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

all-cause mortality amputation cardiovascular mortality diabetes mellitus diabetic foot syndrome foot ulcer haemodialysis survival

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
26 Mar 2021
Historique:
received: 01 02 2021
revised: 21 03 2021
accepted: 23 03 2021
entrez: 3 4 2021
pubmed: 4 4 2021
medline: 4 4 2021
Statut: epublish

Résumé

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. 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. DM patients had a 1.98 times higher probability of all-cause mortality than those without DM ( 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.

Sections du résumé

BACKGROUND 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 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 RESULTS
DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (
CONCLUSIONS 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.

Identifiants

pubmed: 33810545
pii: jcm10071368
doi: 10.3390/jcm10071368
pmc: PMC8037880
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Endocrinol Diabetes Nutr. 2017 May;64(5):241-249
pubmed: 28495319
Int J Cardiol. 2017 Jul 1;238:151-158
pubmed: 28341375
J Ren Care. 2012 Feb;38 Suppl 1:99-108
pubmed: 22348369
Med Clin (Barc). 2005 Dec 3;125(20):770-4
pubmed: 16373026
Nephrol Dial Transplant. 2015 Oct;30(10):1747-66
pubmed: 25943598
Diabetes Care. 2015 Oct;38(10):1852-7
pubmed: 26203063
BMC Endocr Disord. 2019 Jan 3;19(1):1
pubmed: 30606164
Eur J Intern Med. 2020 Jan;71:107-110
pubmed: 31735544
Diabetes Care. 2010 Apr;33(4):878-80
pubmed: 20067975
Diabetes Res Clin Pract. 2016 Jun;116:117-22
pubmed: 27321326
J Renal Inj Prev. 2015 Jun 01;4(2):28-33
pubmed: 26060834
Int J Nephrol. 2016;2016:4870749
pubmed: 27529033
Diabetes Care. 2010 Aug;33(8):1811-6
pubmed: 20484126
Diabetes Care. 2012 Oct;35(10):2021-7
pubmed: 22815299
Diabetes Care. 1999 Mar;22(3):382-7
pubmed: 10097914
Int Wound J. 2015 Oct;12(5):523-6
pubmed: 24103293
J Vasc Surg. 2013 Nov;58(5):1291-9
pubmed: 23810259
Biomed Res Int. 2016;2016:7217586
pubmed: 27190996
Diabetologia. 2012 Nov;55(11):2906-12
pubmed: 22890823
Kidney Int. 2004 Feb;65(2):613-20
pubmed: 14717932
Diabetes Care. 2008 Jul;31(7):1288-92
pubmed: 18390801
Diabetes Care. 2009 Dec;32(12):2193-9
pubmed: 19729524
Intern Med J. 2012 Jun;42(6):e120-8
pubmed: 21999812
J Diabetes Complications. 2017 Mar;31(3):556-561
pubmed: 27993523
Diabetologia. 2011 May;54(5):1190-9
pubmed: 21249490
Iran J Kidney Dis. 2010 Jan;4(1):74-7
pubmed: 20081309
Am J Nephrol. 2018;47(1):30-39
pubmed: 29320770
Diabet Med. 1996 Nov;13(11):967-72
pubmed: 8946155
Diabetes Care. 2003 Feb;26(2):491-4
pubmed: 12547887
Am J Kidney Dis. 2009 Oct;54(4):680-92
pubmed: 19619923
Diabet Med. 2016 Nov;33(11):1493-1498
pubmed: 26666583
Int Wound J. 2016 Oct;13(5):892-903
pubmed: 25601358
Nephron Clin Pract. 2009;112(4):c268-75
pubmed: 19546587
Int Wound J. 2013 Dec;10(6):683-8
pubmed: 22891957
Diabetologia. 2008 May;51(5):747-55
pubmed: 18297261
QJM. 2007 Feb;100(2):65-86
pubmed: 17277315
J Diabetes Complications. 2013 Mar-Apr;27(2):128-33
pubmed: 23062327
J Diabetes Res. 2014;2014:945075
pubmed: 24724108
Hemodial Int. 2017 Jan;21(1):145-147
pubmed: 27624300
Adv Chronic Kidney Dis. 2018 Mar;25(2):121-132
pubmed: 29580576
Iran J Kidney Dis. 2012 Nov;6(6):452-6
pubmed: 23146984
Curr Med Res Opin. 2012 Jun;28(6):999-1055
pubmed: 22502915
Curr Atheroscler Rep. 2017 Oct 2;19(11):44
pubmed: 28971322

Auteurs

Montserrat Dòria (M)

Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain.
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, 08041 Barcelona, Spain.

Àngels Betriu (À)

Sistemes Renals, 2508 Lleida, Spain.

Montserrat Belart (M)

Sistemes Renals, 2508 Lleida, Spain.

Verónica Rosado (V)

Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain.

Marta Hernández (M)

Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain.
Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRBLleida, University of Lleida, 25198 Lleida, Spain.

Felipe Sarro (F)

Department of Nephrology, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain.

Jordi Real (J)

DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.
Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain.

Esmeralda Castelblanco (E)

DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.
Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain.

Linda Roxana Pacheco (LR)

Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain.

Elvira Fernández (E)

Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRBLleida, University of Lleida, 25198 Lleida, Spain.

Josep Franch-Nadal (J)

DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.
Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain.
Primary Health Care Center Raval Sud, Gerència d'Atenció Primaria, Institut Català de la Salut, 08001 Barcelona, Spain.

Mònica Gratacòs (M)

DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.

Dídac Mauricio (D)

Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, 08041 Barcelona, Spain.
DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.
Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain.
Faculty of Medicine, University of Vic (UVIC/UCC), 08500 Vic, Spain.

Classifications MeSH