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Preventing amputations in patients with diabetes and renal disease
Author(s) -
Game Fran
Publication year - 2012
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1716
Subject(s) - medicine , diabetes mellitus , amputation , disease , dialysis , intensive care medicine , diabetic foot , psychological intervention , foot (prosody) , kidney disease , vascular disease , renal replacement therapy , surgery , nursing , endocrinology , linguistics , philosophy
Diabetes remains the single most common cause of both end stage renal disease and non‐traumatic amputation of the lower limb. The available literature confirms a close association between renal disease, peripheral symmetrical neuropathy, peripheral vascular disease, foot ulcers, amputation and survival in patients with diabetes, and suggests that the risk accelerates soon after the start of renal replacement therapy. There are multiple possible mechanisms underlying the association, including the effects of dialysis on tissue hypoxia. At present there are no specific interventions known to improve these pathogenic mechanisms; however, there is evidence to suggest that the organisation of care could have an impact on the onset of foot disease. These patients therefore should have regular foot surveillance, education, and support from appropriate specialists to manage their foot care. All professionals involved in the care of patients with diabetes and renal disease should be aware of the extent to which the patient's feet are at risk. Copyright © 2012 John Wiley & Sons.