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. 2021 Mar 26;10(7):1368.
doi: 10.3390/jcm10071368.

High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

Montserrat Dòria  1   2 , Àngels Betriu  3 , Montserrat Belart  3 , Verónica Rosado  1 , Marta Hernández  1   4 , Felipe Sarro  5 , Jordi Real  6   7 , Esmeralda Castelblanco  6   7 , Linda Roxana Pacheco  1 , Elvira Fernández  4 , Josep Franch-Nadal  6   7   8 , Mònica Gratacòs  6 , Dídac Mauricio  2   6   7   9
Affiliations

High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

Montserrat Dòria et al. J Clin Med. .

Abstract

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.

Keywords: all-cause mortality; amputation; cardiovascular mortality; diabetes mellitus; diabetic foot syndrome; foot ulcer; haemodialysis; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of patients on haemodialysis with studied clinical outcomes at 5-years of follow-up based on the presence of diabetes mellitus (a) and on the presence or absence of previous diabetic foot (b). CV, cardiovascular; DF, diabetic foot (ulcer or amputation); DM, diabetes mellitus; MACE, major adverse CV event.
Figure 2
Figure 2
Adjusted hazard ratios for each of the studied outcomes based on the presence of diabetes mellitus (a) and on the presence or absence of previous diabetic foot (b). CV, cardiovascular; HR, hazard ratio; MACE, major adverse cardiovascular event.
See this image and copyright information in PMC

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