Diabetic Foot Disease in People with Advanced Nephropathy and Those on Renal Dialysis
Diabetic Foot Disease in People with Advanced Nephropathy and Those on Renal Dialysis
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DOI：
10.1007/s11892-010-0128-0
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发表时间：
2010-08-01
影响因子：
4.2
通讯作者：
Boulton, Andrew J. M.
中科院分区：
文献类型：
--
作者：
Ndip, Agbor;Lavery, Lawrence A.;Boulton, Andrew J. M.
在慢性肾脏病（CKD）引起的糖尿病足病风险谱中，终末期肾脏病（ESRD）已成为一种新的独立风险因素。除了在这些个体中操作的神经病变、感染和外周动脉疾病的经典三联征之外，患者的足部自我护理不足和透析中心不提供现场足部护理进一步加剧了风险，因为医疗优先事项被转移到透析本身。因此，CKD和ESRD人群中糖尿病足疾病的负担增加，如高溃疡、截肢和足相关死亡率所示。目前关于糖尿病足部护理的指南应将晚期CKD和ESRD/透析视为足部疾病的独立风险因素，以提醒专业人员并强调预防的机会。最近的研究表明，改善足部的结果时，修脚程序建立在透析单位。
Among the spectrum of risk for diabetic foot disease conferred by chronic kidney disease (CKD), end-stage renal disease (ESRD) has emerged as a novel independent risk factor. Apart from the classical triad of neuropathy, infection, and peripheral arterial disease that operate in these individuals, the risk is further compounded by inadequate foot self-care by patients and by dialysis centers not providing onsite foot care, as medical priorities are diverted to the dialysis itself. Consequently, the burden of diabetic foot disease has increased in the CKD and ESRD population as exemplified by high ulceration, amputation, and foot-related mortality rates. Current guidelines on foot care in diabetes should recognize advanced CKD and ESRD/dialysis as a separate risk factor for foot disease to alert professionals and highlight the opportunity for prevention. Recent studies have demonstrated improved foot outcomes when chiropody programs are instituted within dialysis units.