Abstract：
AIMS:This study examined the predictors for lower extremity amputation (LEA) in patients with diabetic foot ulcers according to kidney function and, in the case of dialysis patients, specifically evaluated the vasculature with the ankle-brachial index (ABI) and Doppler waveforms. METHODS:Among 658 diabetic patients admitted to the Diabetic Foot Care Center, 286 had an estimated glomerular filtration rate (eGFR)≥ 60 ml/min per 1.73 m(2), 275 had an eGFR<60, and 97 patients were under maintenance dialysis. All clinical variables were analyzed. A specialist retrospectively reviewed Doppler images of 78 of the patients in dialysis to evaluate peripheral arterial disease. RESULTS:Forty-two percent of patients with eGFR<60 presented with ABI≤0.90. For ABI values>1.40, the proportion of dialysis patients (31.3%) was greater than the proportion of patients with eGFR<60 (5.3%). Wagner wound classifications, reduced serum albumin levels, and low ABI values were the predictors for major LEA among patients in the non-dialysis groups. Nevertheless, these indicators were not predictive of the risk of amputation in diabetic patients on dialysis. The presence of poor monophasic waveforms in the dorsalis pedis artery or posterior tibial artery served as an independent predictor (odds ratio: 7.61; P=0.008) for major LEA among dialysis patients. The sensitivity and specificity were 88.0% and 59.6%, respectively. CONCLUSIONS:Poor monophasic Doppler waveforms of below-the-knee arteries, commonly found among dialysis patients in treatment for diabetic foot ulcers, can serve as an independent predictor for major LEA.
journal_name
Diabetes Res Clin Practjournal_title
Diabetes research and clinical practiceauthors
Tsai CY,Chu SY,Wen YW,Hsu LA,Chen CC,Peng SH,Huang CH,Sun JH,Huang YYdoi
10.1016/j.diabres.2013.03.017subject
Has Abstractpub_date
2013-05-01 00:00:00pages
181-8issue
2eissn
0168-8227issn
1872-8227pii
S0168-8227(13)00095-8journal_volume
100pub_type
杂志文章abstract：:In the 2013 issue of the International Diabetes Federation (IDF) Diabetes Atlas, the prevalence of diabetes in the Western Pacific (WP) Region was reported to be 8.6% in 2013, or 138 million adults, and estimated to rise to 11.1%, or 201 million adults, in 2035. The prevalence estimates of impaired glucose tolerance i...
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journal_title：Diabetes research and clinical practice
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更新日期：2017-02-01 00:00:00
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更新日期：2017-09-01 00:00:00
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journal_title：Diabetes research and clinical practice
pub_type： 杂志文章
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更新日期：2012-05-01 00:00:00
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更新日期：2017-07-01 00:00:00
