High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain
Por:
Doria, M, Betriu, A, Belart, M, Rosado, V, Hernandez, M, Sarro, F, Real, J, Castelblanco, E, Pacheco, LR, Fernandez, E, Franch-Nadal, J, Gratacos, M, Mauricio, D
Publicada:
1 abr 2021
Resumen:
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.
Filiaciones:
Doria, M:
Univ Hosp Arnau de Vilanova & Santa Maria, Dept Endocrinol & Nutr, Lleida 25198, Spain
Autonomous Univ Barcelona, Dept Endocrinol & Nutr, Hosp Santa Creu & St Pau, Barcelona 08041, Spain
Betriu, A:
Sistemes Renals, Lleida 2508, Spain
Belart, M:
Sistemes Renals, Lleida 2508, Spain
Rosado, V:
Univ Hosp Arnau de Vilanova & Santa Maria, Dept Endocrinol & Nutr, Lleida 25198, Spain
Hernandez, M:
Univ Hosp Arnau de Vilanova & Santa Maria, Dept Endocrinol & Nutr, Lleida 25198, Spain
Univ Lleida, Lleida Inst Biomed Res Dr Pifarre Fdn IRBLleida, Lleida 25198, Spain
Sarro, F:
Univ Hosp Arnau de Vilanova & Santa Maria, Dept Nephrol, Lleida 25198, Spain
Real, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08006, Spain
Inst Salud Carlos III ISCIII, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona 08041, Spain
Castelblanco, E:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08006, Spain
Inst Salud Carlos III ISCIII, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona 08041, Spain
Pacheco, LR:
Univ Hosp Arnau de Vilanova & Santa Maria, Dept Endocrinol & Nutr, Lleida 25198, Spain
Fernandez, E:
Univ Lleida, Lleida Inst Biomed Res Dr Pifarre Fdn IRBLleida, Lleida 25198, Spain
Franch-Nadal, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08006, Spain
Inst Salud Carlos III ISCIII, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona 08041, Spain
Inst Catala Salut, Primary Hlth Care Ctr Raval Sud, Gerencia Atencio Primaria, Barcelona 08001, Spain
Gratacos, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08006, Spain
Mauricio, D:
Autonomous Univ Barcelona, Dept Endocrinol & Nutr, Hosp Santa Creu & St Pau, Barcelona 08041, Spain
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08006, Spain
Inst Salud Carlos III ISCIII, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona 08041, Spain
Univ Vic UVIC UCC, Fac Med, Vic 08500, Spain
gold, Green Published
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