Incidence and risk factors of new foot ulcer among diabetic patients on peritoneal dialysis

Abstract

Objective To study the incidence and risk factors of new foot ulcer among diabetic patients on peritoneal dialysis. Methods This is a single-center prospective cohort study. Clinically-stable diabetic patients on peritoneal dialysis in our renal division were recruited from January 2014 to June 2014. Baseline data including general information, biochemistry data, dialysis adequacy, the dorsalis pedis artery pulse, clinical symptoms of diabetic foot and ankle brachial index were recorded. All patients were followed till to Dec 31, 2015. The outcomes consisted of new foot ulcer, amputation due to foot ulcer or gangrene, and lower limb vascular blood supply revascularization. Results Totally 108 patients were recruited and followed up the average time (17.7±5.6) months. Among 108 patients, 16 cases had a history of diabetic foot ulcer, and 1 case had amputation. During the follow-up, 11 cases (10.2%) had new foot ulcer, 3 cases (2.8%) had amputation due to foot ulcers or gangrene, and 8 cases (7.4%) had lower limb vascular blood supply revascularization. A total of 13 cases (12%) had composite end points with 81.3 times/1000 patients of incidence. Univariate and multivariate Cox regression models showed that the history of foot ulcer was the only independent risk factors for new foot ulcers-related composite end points. Conclusion The incidence of new foot ulcer-related composite end points was 12%, which could be independently predicted by the history of diabetic foot ulcer. Key words: Peritoneal dialysis; Diabetes; Ulcer; Amputation