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BioMed Research International
Volume 2016 (2016), Article ID 7217586, 8 pages
http://dx.doi.org/10.1155/2016/7217586
Research Article

Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

1Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain
2Department of Nephrology, University Hospital Arnau de Vilanova and Santa Maria, Alcalde Rovira Roure 80, 25198 Lleida, Spain
3Biostatistics and Epidemiology Unit, Biomedical Research Institute of Lleida, Alcalde Rovira Roure 80, 25198 Lleida, Spain
4Department of Mathematics, Autonomous University of Barcelona, 08193 Bellaterra, Spain
5DAP-Cat Group, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sardenya 375, 08006 Barcelona, Spain
6CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 3-5, 28029 Madrid, Spain
7Primary Health Care Center Raval Sud, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Avinguda Drassanes 17-21, 08001 Barcelona, Spain
8Department of Endocrinology & Nutrition, Health Sciences Research Institute and Autonomous University of Barcelona, University Hospital Germans Trias i Pujol, Carretera Canyet, S/N, 08916 Badalona, Spain

Received 1 February 2016; Revised 30 March 2016; Accepted 31 March 2016

Academic Editor: Thomas S. Roukis

Copyright © 2016 Montserrat Dòria et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration ( and , resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.