Abstract

The target of this study was to research the gamble of persistent kidney sickness stage 4-5 and dialysis therapy on rate of foot ulceration and significant lower limit removal in contrast with CKD stage 3. All patients receiving dialysis treatment or CKD stages 3 to 5 who visited our hospital between 2006 and 2012 were included in this retrospective study. The prevalence of major amputation and foot ulceration was examined in the medical records. Kaplan-Meier curves and a multivariate Cox proportional hazards model were used to calculate and analyze the time from CKD 3, CKD 4-5, and dialysis treatment until the first foot ulcer and major lower extremity amputation. As potential confounding factors, diabetes mellitus, peripheral neuropathy, peripheral arterial disease, and foot deformities were included. There were a total of 669 people included: 539 patients with CKD 3, 540 patients with CKD 4-5, and 259 on dialysis. For CKD 3, the annual unadjusted incidence rates of foot ulcers were 12 for CKD 3, 47 for CKD 4-5, and 104 for dialysis. When compared to CKD 3, the hazard ratio for the incidence of foot ulceration in multivariate analyses was 7.6 in dialysis treatment and 4.0 in CKD 4-5. The incidence of major amputations had risk ratios of 9.5 and 15, respectively. Compared to CKD 3, CKD 4-5 and dialysis treatment are independent risk factors for foot ulcers and major amputations. In daily clinical practice, the greatest effort is required to prevent foot ulcers and the devastating effects they can have on patients on dialysis or with CKD 4-5.