Prevalence of risk factors for foot ulceration in patients with end-stage renal disease on haemodialysis
Prevalence of risk factors for foot ulceration in patients with end-stage renal disease on haemodialysis
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DOI：
10.1111/j.1445-5994.2011.02605.x
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发表时间：
2012-06-01
影响因子：
2.1
通讯作者：
Tucker, S.
中科院分区：
文献类型：
--
作者：
Kaminski, M.;Frescos, N.;Tucker, S.
背景：终末期肾病（ESRD）与足部溃疡和下肢截肢（LEA）有关。然而，足部溃疡的潜在危险因素在这一人群中受到的关注有限。目的：本研究的目的是调查不合并糖尿病 (DM) 的血液透析 ESRD 患者足部溃疡危险因素的患病率和类型。方法：在 6 周内招募了 190 名患有 ESRD 和/或 DM 的参与者。参与者被分为三组之一：(i) 无 DM 的 ESRD； (ii) 没有 ESRD 的 DM； (iii) 共存 ESRD 和 DM。对参与者进行足部溃疡的危险因素筛查。使用费舍尔精确检验对三组风险因素的患病率和类型进行统计比较。结果：发现足部溃疡的危险因素在 ESRD 人群中非常普遍。与仅患有 DM 的参与者相比，同时患有 ESRD 和 DM 的参与者在周围神经病变 (P= 0.033)、血管功能不全 (P= 0.001) 和鞋类 (P= 0.037) 的危险因素方面表现出统计学显着差异。结论：血液透析终末期肾病人群足部溃疡危险因素患病率较高，且与糖尿病患者相当。患有 ESRD 和 DM 的个体发生足部溃疡和 LEA 的风险更大。这凸显了对于 ESRD 患者定期足部筛查、预防性教育和治疗的重要性，这可能会降低足部溃疡和 LEA 的风险。
Background: End-stage renal disease (ESRD) has been associated with foot ulceration and lower extremity amputation (LEA). However, the underlying risk factors for foot ulceration have received limited attention in this population. Aim: The aim of this study was to investigate the prevalence and type of risk factors for foot ulceration present in patients with ESRD on haemodialysis without the coexistence of diabetes mellitus (DM). Methods: One hundred and ninety participants with ESRD and/or DM were recruited over a 6-week period. Participants were allocated into one of three groups: (i) ESRD without DM; (ii) DM without ESRD; and (iii) coexisting ESRD and DM. Participants were screened for the risk factors for foot ulceration. Statistical comparisons were made between the three groups for both the prevalence and type of risk factors using a Fisher's exact test. Results: Risk factors for foot ulceration were found to be highly prevalent in the ESRD population. Participants with both ESRD and DM exhibited statistically significant differences in risk factor presentation for peripheral neuropathy (P= 0.033), vascular insufficiency (P= 0.001) and footwear (P= 0.037) in comparison with participants with DM alone. Conclusion: There are high prevalence rates of risk factors for foot ulceration in the ESRD population on haemodialysis and are comparable with those with DM. Individuals with coexisting ESRD and DM have an even greater risk for foot ulceration and LEA. This highlights the importance that regular foot screening, preventative education and treatment are necessary for patients with ESRD potentially to reduce the risk of foot ulcerations and LEAs.