High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study...

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Authors: Dòria, Montserrat|||0000-0001-8477-1942, Betriu, Àngels|||0000-0002-0290-4586, Belart, Montserrat, Rosado, Verónica, Hernández García, Marta|||0000-0003-1237-298X, Sarro, Felipe, Real, Jordi|||0000-0002-5979-8948, Castelblanco, Esmeralda|||0000-0002-2061-6270, Pacheco, Linda Roxana, Fernández, Elvira|||0000-0001-5236-1762, Franch-Nadal, Josep|||0000-0002-5175-1555, Gratacòs, Mònica|||0000-0001-7304-7289, Mauricio, Didac|||0000-0002-2868-0250
Format: article
Publication Date:2021
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:255433
Online Access:https://ddd.uab.cat/record/255433
https://dx.doi.org/urn:doi:10.3390/jcm10071368
Access Level:Open access
Keyword:Diabetes mellitus
Haemodialysis
Diabetic foot syndrome
Foot ulcer
Amputation
All-cause mortality
Cardiovascular mortality
Survival
Description
Summary:Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD.

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