Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

Table 1

Overview of reviewed cases in the literature.

Ref	Age	Gender	Type DM	Age at onset	DM complications; other than CKD	RRT	Laboratory			Affected muscles
							HbA1c	CRP (mg/dL)	CK (U/L)
	24	Female	DM I	11	Retinopathy	APD	5.8	97	218	(1) Left vastus lateralis; (2) Left calf
[3]	29	Female	DM I	9	Neuropathy	SPK	5	—	160	Right gastrocnemius
[4]	29	Female	DM I	8	Retinopathy, neuropathy	SPK		—	17	Right gastrocnemius and soleus
[5]	31	Male	DM I	—	Retinopathy, coronaropathy	IHD	—	—	—	Left vastus lateralis
[6]	31	Female	DM I	16	Retinopathy, peripheral vascular disease	IHD	12.4	—	649	(1) Right vastus lateralis; (2) Left thigh; (3) Left calf
[7]	32	Male	DM I	20	Retinopathy, neuropathy, and peripheral vascular disease	IHD	—	—	350	Left vastus muscles
[4]	39	Female	DM I	9	Retinopathy, neuropathy, and ischemic cardiac disease	SPK	5.0	—	21	Right deltoid muscle
[4]	33	Female	DM I	7	Retinopathy, neuropathy	SPK	5.6	—	Normal	Left biceps brachii
	35	Female	DM I	30		APD	8.7	94.2	97	(1) Left vastus medialis and intermedius; (2) Right adductors
[4]	39	Female	DM I	9	Retinopathy, neuropathy	SPK, IHD	5.3	—	83	Right thigh adductors
[8]	49	Male	DM I	—	Retinopathy, neuropathy	CAPD, IDH	7.9	214	—	(1) Left thigh; (2) Right vastus medialis; (3) Left thigh; (4) Right calf
[8]	51	Male	DM I	41	—	IHD	—	216	381	(1) Left buttock; (2) Right semitendinosus
[9]	35	Male	DM II	27	Retinopathy, coronary disease	CAPD	—	—	556	Right vastus medialis
[5]	39	Male	DM II	39	Retinopathy, neuropathy	IHD	—	—	Elevated	Left gastrocnemius
[8]	40	Male	DM II	25	Retinopathy, neuropathy, and peripheral vascular disease	CAPD, IHD	—	—	—	Left rectus femoris
[7]	44	Female	DM II	41	Retinopathy, neuropathy	IHD	—	—	—	(1) Right thigh; (2) Left calf
[9]	49	Female	DM II	34	Retinopathy, neuropathy	CAPD, IHD	—	—	Normal	(1) Left calf; (2) Left gluteal region; (3) Right thigh
[10]	49	Male	DM II	—	Heart failure	IHD	—	35	289	Right rectus femoris
[8]	49	Female	DM II	—	Neuropathy	IHD	—	300	692	Anterior right thigh
[11]	51	Male	DM II	—	—	IHD	—	—	Normal	Left thigh
[12]	55	Male	DM II	35	—	IHD	—	—	463	Left vastus lateralis
[13]	55	Male	DM II	31	Retinopathy, neuropathy	CAPD	—	105	Normal	(1) Left thigh; (2) Right thigh; (3) Right thigh
[5]	56	Female	DM II	—	Retinopathy, neuropathy	CAPD	—	—	Elevated	Left quadriceps
[5]	58	Male	DM II	—	Retinopathy, neuropathy, and peripheral vascular disease	IHD	—	70	Normal	Bilateral quadriceps
[8]	61	Male	DM II	49	Neuropathy, and ischemic heart disease	IHD	8	136	23	Right gastrocnemius and soleus
[14]	61	Female	DM II	45	Retinopathy, neuropathy	IHD	6.7	—	1066	(1) Left vastus medialis; (2) Right thigh; (3) Right calf
[15]	62	Male	DM II	52	Retinopathy	IHD	6.2	—	69	Left triceps and forearm
[15]	63	Male	DM II	38	Retinopathy, neuropathy	IHD	9.5	—	483	Right brachioradialis
[8]	63	Male	DM II	43	Retinopathy, neuropathy, ischemic heart disease, and stroke	IHD	—	361	409	(1) Right vastus medialis and lateralis; (2) Left thigh; (3) Left hamstrings; (4) Left hamstrings
[16]	67	Male	DM II	—	—	KTx	—	—	—	Right gastrocnemius and soleus

DM: diabetes mellitus, CKD: chronic kidney disease, RRT: renal replacement therapy, APD: automated peritoneal dialysis, SPK: simultaneous pancreas kidney transplantation, IHD: intermittent hemodialysis, CAPD: continuous ambulatory peritoneal dialysis, KTx: kidney transplantation, CRP: C-reactive protein, and CK: creatine kinase.