High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

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Abstract

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects.

Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics.

Results: Diabetes patients had a 1.98 times higher probability of all-cause mortality than those without diabetes and 2.42 times higher likelihood of cardiovascular disease development with high mortality and new foot ulcer  or amputation . In the Diabetes patients, only the risk of a new foot ulcer  or amputation was 2.69 times higher among those with previousdiabetic foot syndrome. In patients with diabetes, older age was the only predictor of all-cause and Cardiovascular disease development with high mortality.

Conclusions: Although all-cause and cardiovascular mortality were increased in diabetes patients undergoing hemodialysis  subjects with DM, the presence of diabetes foot ulcers did not modify the excess risk.

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