High rates of lower limb amputation in patients with diabetes end stage renal failure on hemodialysis: is there a causal factor?

Gilhotra, Rajit Aziz, Rodrigues, Beverly Terezinha, Malabu, Usman H., Vangaveti, Venkat, Kan, George, and Sangla, Kunwarjit Singh (2014) High rates of lower limb amputation in patients with diabetes end stage renal failure on hemodialysis: is there a causal factor? In: Abstracts from the 16th International Congress of Endocrinology. From: ICE/ENDO 2014: 16th International Congress of Endocrinology, June 20-24 2014, Chicago, IL, USA.

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Hemodialysis has recently been identified as a risk factor for lower limb amputations (1,2). In spite of this no study has been published that analyses the magnitude and risk factors for amputation amongst hemodialysis patients in rural and remote communities and Indigenous Australian residents of the Tropical Northern region where diabetes and kidney disease are quite common (3). The objectives of this study were to document trends in prevalence and identify risk factors of non-traumatic lower limb amputations in diabetes subjects treated with hemodialysis in the region. 155 current haemodialysis patients attending the Townsville Dialysis Centre were included in the study. Odds ratio and χ2 tests were performed to identify variables most strongly associated with amputation. We identified a 13.6% prevalence of lower limb amputation in 155 subjects on hemodialysis at our centre. The major risk factors of amputations in the cohort were history of ulceration (RR 24.74 [95%CI 6.02-101.76] p<0.0001) and the presence of diabetes (RR 23.19 [95%CI 1.43-375.49] p=0.027). Other variables tested but fell short of statistical significance included: Indigenous background, smoking history, gender and type of ulceration. Thus, patients with end stage renal failure on hemodialysis who have a past history of ulceration and have diabetes mellitus are at higher risk of having lower limb amputation. Primary prevention of diabetes in the sub-population may help in reducing the limb loss. In-depth analysis of the data will be presented at the conference.

Item ID: 33855
Item Type: Conference Item (Abstract / Summary)
Date Deposited: 24 Sep 2014 00:18
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 75%
92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 25%
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