Frequency of risk factors for foot ulceration in individuals with chronic kidney disease
Frequency of risk factors for foot ulceration in individuals with chronic kidney disease
复制标题
DOI：
10.1111/j.1445-5994.2007.01528.x
复制
发表时间：
2008-05-01
影响因子：
2.1
通讯作者：
Wraight, P. R.
中科院分区：
文献类型：
--
作者：
Freeman, A.;May, K.;Wraight, P. R.
背景：尽管慢性肾脏病（CKD）与足部溃疡有关，但其病理机制尚不清楚。这项初步研究旨在调查无糖尿病的CKD患者足部溃疡的风险因素。本研究的目的是建立慢性肾脏病患者的足部溃疡的风险状态，并确定特定的足部溃疡的危险因素最普遍在this group.Methods：100例门诊患者从大都市医院招募，并分配到四个组之一：（i）控制：既不糖尿病也不慢性肾脏病，（ii）糖尿病，（iii）共存的慢性肾脏病和糖尿病和（iv）慢性肾脏病。对所有参与者的既往/当前足部溃疡、周围神经病变、血管功能不全、结构畸形和皮肤病理进行评估。各组之间进行比较，关于患病率的这些factors.Results：参与者与CKD谁没有糖尿病显示没有显着差异，从那些单独的糖尿病的危险因素介绍。无糖尿病的CKD患者中，36%有周围神经病变，20%有血管功能不全，24%有周围神经病变和结构畸形的共同表现。总体而言，CKD和糖尿病患者的既往/当前足部溃疡、周围神经病变和血管功能不全的发生率最高，该组均显著高于对照组（P < 0.05）。八个10个参与者发现有一个过去/目前的足部溃疡是在终末期kidney failure.Conclusion：CKD的个人经常显示足部溃疡的危险因素。风险因素在糖尿病患者中更为普遍，随着进展至终末期肾衰竭，足部溃疡变得更加频繁。因此，应将风险评估和患者意识策略扩展至包括所有CKD患者，以减少未来足部溃疡的发展。
Background: Although chronic kidney disease (CKD) has been associated with foot ulceration, the pathological pathway involved remains unclear. This pilot study was designed to investigate the risk factors for foot ulceration in individuals with CKD who do not have diabetes. The aims of this study were to establish the risk status for foot ulceration in individuals with CKD and to identify the particular foot ulcer risk factors most prevalent in this group.Methods: One hundred outpatients were recruited from a metropolitan hospital and allocated into one of four groups: (i) control: neither diabetes nor CKD, (ii) diabetes alone, (iii) coexisting CKD and diabetes and (iv) CKD alone. All participants were assessed for past/current foot ulcers, peripheral neuropathy, vascular insufficiency, structural deformity and skin pathology. Comparisons were made between the groups regarding the prevalence of these factors.Results: Participants with CKD who did not have diabetes displayed no significant differences in risk factor presentation from those with diabetes alone. Of the participants with CKD and no diabetes, 36% had peripheral neuropathy, 20% had vascular insufficiency and 24% had the copresentation of peripheral neuropathy and structural deformity. Overall, participants with both CKD and diabetes had the highest presentation of past/current foot ulcers, peripheral neuropathy and vascular insufficiency, all significantly more frequent in this group than in controls (P < 0.05). Eight of the total 10 participants found to have a past/current foot ulcer were in end-stage kidney failure.Conclusion: Individuals with CKD frequently display risk factors for foot ulceration. Risk factors are more prevalent in individuals who also have diabetes and foot ulcers become more frequent with progression to end-stage kidney failure. Risk assessment and patient awareness strategies should therefore be extended to include all patients with CKD so as to reduce future foot ulcer development.