Increased Risk of Lower-Extremity Amputation Among Caucasian Diabetic Patients on Dialysis
- Stephan Morbach, MD1,
- Christoph Quante, MD1,
- Hermann Rudolf Ochs, MD1,
- Franz Gaschler, MD2,
- Jean-Mario Pallast, MD3 and
- Udo Knevels, MD3
- 1Marienkrankenhaus Departments of Internal Medicine, Diabetic Foot Clinic, and
- 2Vascular Surgery, Soest, Germany, and the
- 3Limited Care Dialysis Unit, Soest, Germany
In two recent issues of Diabetes Care, high amputation rates among Maori people from New Zealand (1) and Native Americans (2) with diabetes on dialysis were reported. We would like to add some information concerning Caucasians with diabetic foot syndrome and advanced renal disease from a prospective sample of 400 consecutive patients treated at our diabetic foot clinic. Similar to chronic renal insufficiency (defined by serum creatinine concentration 1.5–3.0 mg/dl), chronic renal failure and end-stage renal disease (ESRD) should be regarded as a continuum (3). We analyzed the frequency of these conditions among the entire study population and compared presentation features and outcomes among the concerned patients and among diabetic foot patients without obvious renal impairment.
At the time of presentation for the index foot lesion, 14 patients (4%, group …
