Adults with kidney failure who receive foot, ankle care have lower chance of amputation
Click Here to Manage Email Alerts
Key takeaways:
- Patients who received foot and ankle care had an 11% lower likelihood of death.
- These patients had a 9% lower likelihood of major amputation compared with patients who did not.
Adults with kidney failure at risk for diabetes-related foot ulcers who receive foot and ankle care may have a lower chance of diabetes-related amputation and death, according to recently published data.
“Individuals undergoing kidney replacement therapy face a [five]fold increased risk of [diabetic foot ulcers] DFUs compared with those with chronic kidney disease (stage 4 or 5) not receiving dialysis,” Tze-Woei Tan, MBBS, MPH, of the Keck School of Medicine of University of Southern California, Los Angeles, wrote with colleagues. “This study sought to elucidate whether the outcomes of DFUs differ between patients with kidney failure who had preemptive foot and ankle care by podiatrists.”
Researchers conducted a retrospective cohort study of 14,935 Medicare recipients, aged 40 years or older, with type 2 diabetes who were on dialysis for kidney failure. Using data from the United States Renal Data System, investigators examined podiatry care on outcomes of DFUs. Major amputation and a composite of death and/or major amputation were the primary outcomes.
Among the study population, 18.4% of patients received care by podiatrists in the 3 months before index DFU diagnosis. At an average follow-up of 13.5 months, 70% of patients who received podiatric care died and/or had a major amputation compared with 74% of patients in the group that did not have podiatric care. The 36-month survival probability for these groups was 26.3% and 22.8%, respectively.
Patients who had foot and ankle care had an 11% lower likelihood of death and/or amputation and a 9% lower likelihood of major amputation compared with patients who did not have foot and ankle care.
“For individuals with kidney failure receiving dialysis and susceptible to diabetes-related limb loss, receiving foot and ankle care by podiatrists before the onset of diabetic foot ulcers may be associated with improved outcomes,” according to Tan and colleagues. “While future fully powered studies are needed to further support these findings, these results suggest positive potential benefits for preventive foot and ankle care to mitigate complications in this high-risk population.”
Collapse
Click Here to Manage Email Alerts