Stage 4 and 5 chronic kidney disease as an independent risk factor for foot ulceration and amputation.

Otte, J. (2013) Stage 4 and 5 chronic kidney disease as an independent risk factor for foot ulceration and amputation. thesis, Medicine.

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Abstract

Objective: To determine whether stage 4 or 5 chronic kidney disease (CKD 4-5) and dialysis are independent risk factor for the development of foot ulceration (FU) and lower-extremity amputation (LEA) compared to stage 3 chronic kidney disease (CKD 3), independent of diabetes mellitus and other known risk factors. Methods: In this retrospective study, individuals were included if they were checked between 2006 and 2012 at least once in our hospital because of CKD 3 to 5, or because of dialysis treatment. Three dates were collected from all individuals and used to form three groups: first date of CKD 3, first date of CKD 4-5 and first date of dialysis treatment. Medical records were reviewed for presence from dates from FU and LEA. The time from CKD 3, CKD 4-5 and dialysis until development of FU and LEA were calculated and analyzed by multivariate logistic regression. Other known risk factors for development of FU an LEA were analyzed for potential confounding. Results: With CKD 3 as a reference, the hazard ratio’s (HR) for the development of FU in CKD 4-5 were 4.0 (95% CI 2.6-6.3), and in dialysis 7.6 (95% CI 4.8-12.1). HR for LEA were respectively 9.5 (95% CI 2.1-43) and 15 (95% CI 3.3-71). Conclusion: CKD 4-5 is an independent risk factor for the development of FU and LEA compared to CKD3, although the risk is not as high in comparison to dialysis.

Item Type:	Thesis (Thesis)
Supervisor name:	Woittiez, Dr. A.J.
Supervisor name:	Netten, Dr. J. van and Interne geneeskunde/nefrologie and ZGT Almelo
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1653

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