Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study

Foot ulceration (FU) remains a serious concern for patients worldwide. We analyzed the incidence, risk factors, and outcome of FU in hemodialysis (HD) patients. A retrospective cohort study was conducted for 252 HD patients who were followed up for 5 years. Patients were categorized according to whe...

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Main Authors: Hassan Al-Thani, Ayman El-Menyar, Valsa Koshy, Ahmed Hussein, Ahmed Sharaf, Mohammad Asim, Ahmed Sadek
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2014/945075
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author Hassan Al-Thani
Ayman El-Menyar
Valsa Koshy
Ahmed Hussein
Ahmed Sharaf
Mohammad Asim
Ahmed Sadek
author_facet Hassan Al-Thani
Ayman El-Menyar
Valsa Koshy
Ahmed Hussein
Ahmed Sharaf
Mohammad Asim
Ahmed Sadek
author_sort Hassan Al-Thani
collection DOAJ
description Foot ulceration (FU) remains a serious concern for patients worldwide. We analyzed the incidence, risk factors, and outcome of FU in hemodialysis (HD) patients. A retrospective cohort study was conducted for 252 HD patients who were followed up for 5 years. Patients were categorized according to whether they developed FU or not. The FU group (17%) was older and had significantly higher incidence of nephropathy, retinopathy, peripheral (PAD), coronary artery disease (CAD), and diabetes mellitus (DM) as compared to no-FU group. FU group had higher frequency of major amputation (P=0.001) and HD vascular access (P=0.01). Patients with combined DM and PAD had a 10-fold increased risk of FU in comparison to those who had DM alone. Presence of PAD was the main independent predictor for development of FU in HD with an adjusted odd ratio (aOR) of 16.0 (95% CI: 4.41–62.18; P=0.001). After adjusting for age, sex, and CAD, predictors for mortality were PAD (aOR 4.3), FU (aOR 3.6), and DM (aOR 2.6). FU is common in HD patients regardless of DM. However, the presence of PAD is significantly associated with more FU and mortality in HD. HD patients need intensive foot care and warrant progressive modification of vascular risk factors.
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spelling doaj-art-26ee26e8eb574df584e36e609a55197a2025-08-20T02:04:23ZengWileyJournal of Diabetes Research2314-67452314-67532014-01-01201410.1155/2014/945075945075Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational StudyHassan Al-Thani0Ayman El-Menyar1Valsa Koshy2Ahmed Hussein3Ahmed Sharaf4Mohammad Asim5Ahmed Sadek6Vascular Surgery, Department of Surgery, Hamad General Hospital, HMC, P.O. Box 3050, Doha, QatarClinical Research, Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarVascular Surgery, Department of Surgery, Hamad General Hospital, HMC, P.O. Box 3050, Doha, QatarVascular Surgery, Department of Surgery, Hamad General Hospital, HMC, P.O. Box 3050, Doha, QatarVascular Surgery, Department of Surgery, Hamad General Hospital, HMC, P.O. Box 3050, Doha, QatarClinical Research, Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarVascular Surgery, Department of Surgery, Hamad General Hospital, HMC, P.O. Box 3050, Doha, QatarFoot ulceration (FU) remains a serious concern for patients worldwide. We analyzed the incidence, risk factors, and outcome of FU in hemodialysis (HD) patients. A retrospective cohort study was conducted for 252 HD patients who were followed up for 5 years. Patients were categorized according to whether they developed FU or not. The FU group (17%) was older and had significantly higher incidence of nephropathy, retinopathy, peripheral (PAD), coronary artery disease (CAD), and diabetes mellitus (DM) as compared to no-FU group. FU group had higher frequency of major amputation (P=0.001) and HD vascular access (P=0.01). Patients with combined DM and PAD had a 10-fold increased risk of FU in comparison to those who had DM alone. Presence of PAD was the main independent predictor for development of FU in HD with an adjusted odd ratio (aOR) of 16.0 (95% CI: 4.41–62.18; P=0.001). After adjusting for age, sex, and CAD, predictors for mortality were PAD (aOR 4.3), FU (aOR 3.6), and DM (aOR 2.6). FU is common in HD patients regardless of DM. However, the presence of PAD is significantly associated with more FU and mortality in HD. HD patients need intensive foot care and warrant progressive modification of vascular risk factors.http://dx.doi.org/10.1155/2014/945075
spellingShingle Hassan Al-Thani
Ayman El-Menyar
Valsa Koshy
Ahmed Hussein
Ahmed Sharaf
Mohammad Asim
Ahmed Sadek
Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
Journal of Diabetes Research
title Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
title_full Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
title_fullStr Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
title_full_unstemmed Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
title_short Implications of Foot Ulceration in Hemodialysis Patients: A 5-Year Observational Study
title_sort implications of foot ulceration in hemodialysis patients a 5 year observational study
url http://dx.doi.org/10.1155/2014/945075
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