title: Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain.
abstract: Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.
authors.affiliation: Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Dòria
authors.affiliation: Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Rosado
authors.affiliation: Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Linda Roxana
authors.initials: LR
authors.lastname: Pacheco
authors.affiliation: Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Marta
authors.identifier: 0000-0003-1237-298X
authors.initials: M
authors.lastname: Hernández
authors.affiliation: Department of Nephrology, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Àngels
authors.initials: À
authors.lastname: Betriu
authors.affiliation: Biostatistics and Epidemiology Unit, Biomedical Research Institute of Lleida, Alcalde Rovira Roure 80, 25198 Lleida, Spain; Department of Mathematics, Autonomous University of Barcelona, 08193 Bellaterra, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Valls
authors.affiliation: DAP-Cat Group, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sardenya 375, 08006 Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 3-5, 28029 Madrid, Spain; Primary Health Care Center Raval Sud, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Avinguda Drassanes 17-21, 08001 Barcelona, Spain.
authors.forename: Josep
authors.identifier: 0000-0002-5175-1555
authors.initials: J
authors.lastname: Franch-Nadal
authors.affiliation: Department of Nephrology, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain.
authors.forename: Elvira
authors.identifier: 0000-0001-5236-1762
authors.initials: E
authors.lastname: Fernández
authors.affiliation: DAP-Cat Group, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sardenya 375, 08006 Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 3-5, 28029 Madrid, Spain; Department of Endocrinology & Nutrition, Health Sciences Research Institute and Autonomous University of Barcelona, University Hospital Germans Trias i Pujol, Carretera Canyet, S/N, 08916 Badalona, Spain.
authors.forename: Dídac
authors.initials: D
authors.lastname: Mauricio
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D003710:Demography; D017719:Diabetic Foot / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D006435:Renal Dialysis; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology