Abstract
Abstract Background and Aims Peripheral arterial disease affects very commonly CKD patients on dialysis. Frequently such injuries precede severe complications that lead to hospitalizations, amputations and even death. Objectives: Study the prevalence of ulcers and amputation on dialysis, analyze related risk factors, post-surgical results and establish a prevention program. Method Descriptive, observational, retrospective (7 years), single-center study in patients with CKD on dialysis. Results 202 patients (12 PD 190 HD), 67 active and 135 off dialysis, 127 men 75 women. Average age 69 years. Average time on dialysis 47 months. Vascular access: 56%, native fistula 37% catheter 7% prosthesis. Cause CKD 30,2% ND, 22.8% NAS. 95.54% HBP, 46.53% DM 26.73% Ischemic heart disease, 31.19% chronic ischemia, 26.24% had intermittent claudication, 12.38 % had all the comorbidities indicated. Higher comorbidity in males M:F 4:1. 53.47% ex-smokers or active habit. Ulcers 29.7% (40 men 20 women), 76.67%, diabetics. Half of the patients with DM (48.94%) presented ulcers. The most frequent was vascular ulcer (43.67%) followed by that associated with diabetic foot (26.67%) and pressure ulcer 15%. Amputations (11 major and 13 minor) in 24 patients (16 men 8 women) with a prevalence: overall 12%, DM 22.34%, with ulcers 40% and 46% if they are diabetics. Analytics in amputees. Average: PTH 352 ng/dl, Phosphorus 4.4 mg/dl, Vitamin D 19 mg/dl, Albumin 3.3g/dl, hypercholesterolemia in 20%. 17 patients with chronic ischemia were revascularized (76.47% ended in amputation). Mortality: 88 patients died (43.56%), of which 41 were patients with ulcers (68.33%) and 20 were amputees (83.33%, 3 early mortality and 17 late mortality). Conclusion The prevalence of amputations on dialysis is high. Most are male, DM with high cardiovascular comorbidity and a previous history of ulcers. Mortality increases in patients with CKDG5D with ulcers and amputees. There is a need for 11dialysis without socks” programs for early detection of dialysis ulcers to reduce the incidence of amputees.
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