High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

Abstract

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD.

Risk factors of foot ulcers in patients with end‐stage renal disease on dialysis: A meta‐analysis

“…After carefully reading the full text and considering the inclusion criteria and relevant outcome measures of the studies, articles comprising a total of 1620 patients were selected. A flowchart illustrating the selection process of articles from 14 to 19 is presented in Figure 1 14–19 . Table 1 provides an overview of the basic characteristics of the included studies.…”

“…A flowchart illustrating the selection process of articles from 14 to 19 is presented in Figure 1 . 14 , 15 , 16 , 17 , 18 , 19 Table 1 provides an overview of the basic characteristics of the included studies.…”