October 2017

Dialysis patients, even without diabetes, have high risk for ulceration, amputation

In the moment: Footcare

By Jordana Bieze Foster

Patients with end-stage renal disease undergoing dialysis are at high risk for foot ulcerations and amputation, regardless of whether they also have diabetes, according to research from La Trobe University in Melbourne, Australia, that underscores the need for foot screening in this population.

Investigators analyzed 450 patients, half of whom had diabetes. Foot ulcers were present in 10%, 21.6% had a history of foot ulceration, and 10.2% had undergone a lower extremity amputation.

The authors found a prevalence of 50.2% for peripheral neuropathy (including 35.3% of those without diabetes) and 52.4% for peripheral arterial disease (PAD); however, only 15.6% of neuropathy cases and 17.6% of PAD cases were documented in patients’ medical records prior to the study.

Diabetes was not a significant risk factor for either foot ulceration or amputation. Previous amputation, PAD, and serum albumin were associated with foot ulceration; previous and/or current ulceration and foot deformity were associated with amputation. The findings were published in September by BMC Nephrology.


Kaminski MR, Raspovic A, McMahon LP, et al. Factors associated with foot ulceration and amputation in adults on dialysis: a cross-sectional observational study. BMC Nephrol 2017;18(1):293.

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