Micro- and macrovascular complications and risk factors for foot ulceration and amputation in individuals receiving dialysis with and without diabetes
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Introduction: This study examined the prevalence of microvascular and macrovascular complications in people receiving dialysis with and without diabetes and investigated independent risk factors for foot ulcers and lower-extremity amputations. Methods: We performed a cross-sectional study of 119 individuals with diabetes and 219 individuals without diabetes receiving chronic dialysis during June 2019 at the Department of Nephrology, Rigshospitalet, University of Copenhagen, Denmark. Effects of diabetes and other risk factors were assessed by log-binomial regression. Prevalence data were compared with a historical control group of 38 individuals with diabetes receiving dialysis examined in 2004 in the same department. Results: We found that persons with diabetes had a twofold higher risk ratio of current (unadjusted risk ratio 2.2 [95% CI 1.1, 4.7]) and previous foot ulcer (2.5 [1.7, 3.7]) and a fourfold higher risk ratio of lower-extremity amputation (4.2 [2.1, 8.6]) in comparison with persons without diabetes (all p <.05). Furthermore, persons with diabetes had a 70% increased risk ratio of myocardial infarction (1.7 [1.0–2.8], p =.041). In multivariable-adjusted analysis, current foot ulcer was independently associated with previous foot ulcer (adjusted risk ratio 4.0 [95% CI 1.8, 8.9]), while lower-extremity amputation was independently associated with diabetes (3.8 [1.8, 8.2]) and male sex (4.1 [1.5, 11.3]) (all p <.01). Conclusions: Individuals with diabetes receiving dialysis had a higher prevalence of foot ulcer, lower-extremity amputation and myocardial infarction compared to individuals without diabetes. Previous foot ulcer was the most important risk factor for current foot ulcer, while diabetes and male sex were important risk factors for lower-extremity amputation.
Original language | English |
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Article number | e00305 |
Journal | Endocrinology, Diabetes and Metabolism |
Volume | 5 |
Issue number | 1 |
ISSN | 2398-9238 |
DOIs | |
Publication status | Published - 2022 |
Bibliographical note
Publisher Copyright:
© 2021 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
- diabetes complications, diabetes mellitus, diabetic foot, dialysis, end-stage renal disease, epidemiology
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