Prevalence of foot ulcers in dialysis‐dependent patients

Brekelmans, Wouter; Burg, Boudewijn L S Borger van der; Vroom, Michiel A; Kreuger, Marrigje J; Meer, Anita M Schrander van der; Hoencamp, Rigo

doi:10.1111/wrr.12750

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Yan,

Yao,

Wang

et al. 2023

International Wound Journal

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The present study aims to assess the risk factors for foot ulcers in patients undergoing dialysis for end‐stage renal disease (ESRD) and to provide evidence‐based guidance for prevention and treatment. A systematic search was conducted on PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data from the database inception until May 2023 to identify relevant studies investigating the risk factors for foot ulcers in dialysis patients with ESRD. Two independent researchers conducted the literature screening and data extraction. The meta‐analysis was performed using STATA 17.0 software. Ultimately, six articles comprising 1620 patients were included for analysis. The meta‐analysis revealed that male (OR, 1.464; 95% CI: 1.082–1.980, p = 0.013), hypertension (OR, 1.781; 95% CI: 1.293–2.4550, p < 0.001), peripheral artery disease (PAD) (OR, 5.014; 95% CI: 2.514–9.998, p < 0.001), type 1 diabetes mellitus (T1DM) (OR, 2.993; 95% CI: 1.477–6.065, p = 0.002) and type 2 diabetes mellitus (T2DM) (OR, 2.498; 95% CI:1.466–4.256, p = 0.001) were risk factors for foot ulcers in dialysis patients with ESRD. Conversely, the female sex (OR, 0.683; 95% CI: 0.505–0.924, p = 0.013) was a protective factor against foot ulcers. Our analysis revealed that male sex, hypertension, PAD, T1DM and T2DM were risk factors for foot ulcers in patients undergoing dialysis for ESRD. Conversely, the female sex was a protective factor against foot ulcers. Therefore, it is crucial to strengthen health education that targets patients with these risk factors and regularly screen high‐risk individuals. Early detection and treatment can help delay disease progression.

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Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Yan,

Yao,

Wang

et al. 2023

International Wound Journal

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“…7,8 The prevalence of foot ulceration varies among patients undergoing hemodialysis (HD) but has been associated with many conditions, including uremia, anemia, uremic neuropathy, edema in the lower extremities, hypoalbuminemia, susceptibility to infections, and decreased pedal skin perfusion during HD. [9][10][11][12] Chronic foot ulcers lead to other serious lower extremity complications such as deep infections that require hospitalization (ie, cellulitis, osteomyelitis, periostitis, other infections of the bone, gangrene), extremity loss, and foot-related mortality, and their treatment and management are becoming increasingly difficult and pose a significant financial burden on health expenditures. 13 Such complications are usually preventable when modifiable risk factors are identified and managed early.…”

Section: Introductionmentioning

confidence: 99%

“…Although the main determinants of lower extremity injury and amputation are not fully understood in this patient group, it is known that renal failure affects wound healing 7,8 . The prevalence of foot ulceration varies among patients undergoing hemodialysis (HD) but has been associated with many conditions, including uremia, anemia, uremic neuropathy, edema in the lower extremities, hypoalbuminemia, susceptibility to infections, and decreased pedal skin perfusion during HD 9–12 …”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment

Özdemir,

Nural

2024

Adv Skin Wound Care

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OBJECTIVE To determine the prevalence and risk factors of foot ulceration in patients receiving hemodialysis treatment. METHODS A total of 180 patients who received hemodialysis treatment in two state hospitals and a private health center between April 2017 and September 2017 were included in the study. The researchers collected data using a patient information form and by conducting physical evaluation of the lower extremities. They used the diabetic foot risk assessment algorithm to classify risk according to the data obtained. RESULTS Of the patients receiving hemodialysis treatment, 6.7% had foot ulceration, 19.4% had a history of foot ulceration, and 8.3% had a history of hospitalization associated with ulceration in a lower extremity. Infected foot ulceration was the most common (6.1%) cause of hospitalizations. In the group with current or past foot ulceration, diabetic nephropathy was the most common etiologic factor of end-stage kidney disease (48.6%); there was a significant between-group difference in diabetic nephropathy (P < .05). Etiologic factors had a significant effect on foot ulcerations: As determined by univariate logistic regression, diabetes (odds ratio [OR], 2.727; P < .05), presence of neuropathy (OR, 4.208; P < .05), low-density lipoprotein cholesterol (OR, 1.013; P < .05), and serum albumin (OR, 0.302; P < .036) all had a statistically significant effect on the presence of foot ulcerations. CONCLUSIONS Patients receiving hemodialysis treatment are at high risk for foot ulceration. Therefore, patient awareness strategies should be expanded to include individuals with end-stage renal disease regardless of diabetes status. Clinical and dialysis nurses should educate these patients about foot ulcerations and foot health to prevent ulcer development.

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“…factors including acute exacerbation of diseases, as well as hospitalization (5,6). At present, studies on DF mainly focus on patients with ulcer-related complaints, while studies on those seeking inpatient care for non-ulcer reasons are limited (7). This is a neglected but relatively large group, which might suffer from more non-standard treatments for DF.…”

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confidence: 99%

Clinical characteristics of inpatients with diabetic foot ulcer admitted with non-ulcer complaints: a retrospective study

Li,

Qin

et al. 2023

Preprint

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Background: Patients with diabetic foot (DF) typically have other diabetic complications and comorbidities. DF inpatients admitted with non-ulcer complaints are a neglected group, that might suffer from more non-standard treatments. This study intends to address their clinical characteristics, and clarify the problems existing in the diagnosis and treatment process. Methods: This study was retrospective. Subjects were eligible inpatients with diabetic foot ulcer (DFU) identified through the relevant International Classification of Disease tenth revision (ICD-10) codes. A structured questionnaire was designed and constructed in sections to collect medical records data. Admission complaints were determined by combining final diagnosis and clinical documentation, and categorized as: ulcer-related or non-ulcer complaints. All discharged patients were followed for readmission and death. Results: A total of 264 DFU inpatients were included in the final analysis, of which, 80 (30.3%) were admitted with non-ulcer complaints. A total of 82.5% of the DFU inpatients with non-ulcer complaints were admitted to departments without DF specialists. IWGDF/IDSA grade, cerebrovascular diseases, chronic kidney disease, infection in other parts, glycosylated hemoglobin A1c and source of hospitalization expenses were the independent influencing factors for admission with non-ulcer complaints (all P < 0.05). Only 11.3% of the patients with non-ulcer complaints had ever been treated by a DF specialist and/or in a clinical setting with DF specialists, and up to 81.4% had never sought medical help before admission. After admission, 75.0% of the DFU inpatients with non-ulcer complaints received local wound care, and only 12.5% received symptomatic analgesic treatment. There was no significant difference in clinical outcomes between the two groups either in or out-of hospital after discharge (all P > 0.05). Conclusions: Approximately one-third of inpatients with DFU were admitted with non-ulcer complaints and most of them were admitted to departments without DF specialists. Inpatients with non-ulcer complaints had a milder wound severity but more and heavier comorbidities and worse organ function. These patients did not receive standardized diagnosis and treatment for DFU either before or after admission. They and the medical staff in related departments should receive more attention, education and training.

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Prevalence of foot ulcers in dialysis‐dependent patients

Cited by 7 publications

References 33 publications

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

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

Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment

Clinical characteristics of inpatients with diabetic foot ulcer admitted with non-ulcer complaints: a retrospective study

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