Poor prognosis after lower-limb amputation irrespective of diabetes status in patients undergoing hemodialysis.

Autor: Tamaki A; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.; Nagasaki Renal Center, Nagasaki, Japan., Kitamura M; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.; Nagasaki Renal Center, Nagasaki, Japan., Yamaguchi K; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.; Nagasaki Renal Center, Nagasaki, Japan., Notomi S; Nagasaki Renal Center, Nagasaki, Japan., Tomura H; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.; Nagasaki Renal Center, Nagasaki, Japan., Sawase K; Nagasaki Renal Center, Nagasaki, Japan., Hashiguchi J; Nagasaki Renal Center, Nagasaki, Japan., Harada T; Nagasaki Renal Center, Nagasaki, Japan., Funakoshi S; Nagasaki Renal Center, Nagasaki, Japan., Takazono T; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan., Mukae H; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan., Nishino T; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Jazyk: angličtina
Zdroj: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy [Ther Apher Dial] 2023 Jun; Vol. 27 (3), pp. 495-504. Date of Electronic Publication: 2022 Nov 11.
DOI: 10.1111/1744-9987.13947
Abstrakt: Introduction: Diabetes mellitus is one of the most important risk factors for lower-limb amputation in patients undergoing hemodialysis. However, the influence of diabetes mellitus on survival after lower-limb amputation is unknown.
Methods: Patients who underwent lower-limb amputation since 1996 (amputation group) and those who underwent hemodialysis during 2011-2012 (control group) were included and were followed up until July 2022.
Results: There were 70 patients (age: 66.3 ± 8.2 years, 80% male, 77% diabetic) in the amputation group and 328 (age: 67.5 ± 13.5 years, 56% male, 33% diabetic) in the control group. The amputation group showed a poorer prognosis than the control group (hazard ratio [HR]: 2.41, p < 0.001). In the control group, patients with diabetes exhibited poorer survival than those without diabetes (HR: 1.86, p < 0.001). In the amputation group, patients with diabetes exhibited improved survival (HR: 0.47, p = 0.02).
Conclusion: Patients undergoing hemodialysis who underwent lower-limb amputation exhibited a poor prognosis, irrespective of diabetes status.
(© 2022 International Society for Apheresis and Japanese Society for Apheresis.)
Databáze: MEDLINE
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