scholarly journals Prevalence and Risk Factors of Lower Limb Amputation in Patients with End-Stage Renal Failure on Dialysis: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Rajit A. Gilhotra ◽  
Beverly T. Rodrigues ◽  
Venkat N. Vangaveti ◽  
Usman H. Malabu
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Renal Failure ◽  
Risk Factor ◽  
Lower Limb ◽  
Renal Dialysis ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
End Stage Renal Failure ◽  
End Stage

Background.Renal dialysis has recently been recognised as a risk factor for lower limb amputation (LLA). However, exact rates and associated risk factors for the LLA are incompletely understood.Aim.Prevalence and risk factors of LLA in end-stage renal failure (ESRF) subjects on renal dialysis were investigated from the existing literature.Methods.Published data on the subject were derived from MEDLINE, PubMed, and Google Scholar search of English language literature from January 1, 1980, to July 31, 2015, using designated key words.Results.Seventy studies were identified out of which 6 full-text published studies were included in this systematic review of which 5 included patients on haemodialysis alone and one included patients on both haemodialysis and peritoneal dialysis. The reported findings on prevalence of amputation in the renal failure on dialysis cohort ranged from 1.7% to 13.4%. Five out of the six studies identified diabetes as the leading risk factor for amputation in subjects with ESRF on renal dialysis. Other risk factors identified were high haemoglobin A1c, elevated c-reactive protein, and low serum albumin.Conclusions.This review demonstrates high rate of LLA in ESRF patients receiving dialysis therapy. It has also identified diabetes and markers of inflammation as risk factors of amputation in ESRF subjects on dialysis.

scholarly journals Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

Renal Failure ◽  
2016 ◽  
Vol 38 (7) ◽  
pp. 1036-1043 ◽  
Author(s):  
Rajit A. Gilhotra ◽  
Beverly T. Rodrigues ◽  
Venkat N. Vangaveti ◽  
George Kan ◽  
David Porter ◽  
...  
Keyword(s):  
Renal Failure ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
End Stage Renal Failure ◽  
End Stage

scholarly journals End-Stage Renal Failure Is an Independent Risk Factor for 1-Year Mortality After Hip Fracture Surgery

2018 ◽  
Vol 9 ◽  
pp. 215145931877056 ◽  
Author(s):  
Louise Woon Theng Lo ◽  
Xu Yanling ◽  
Andrew Chia Chen Chou ◽  
Tet Sen Howe ◽  
John Carson Allen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Risk Factor ◽  
Hip Fracture ◽  
Independent Risk Factor ◽  
Postoperative Mortality ◽  
End Stage Renal Failure ◽  
Hip Fracture Surgery ◽  
End Stage ◽  
Fracture Surgery

Introduction: End-stage renal failure (ESRF) with its associated comorbidities increase postoperative mortality in hip fracture patients. This study investigated the association of ESRF with various comorbidities in patients on dialysis and assessed rates ESRF as an independent risk factor for all-cause postoperative 1- year mortality rates. Methods: This was a retrospective cohort study on patients aged 55 years and older who underwent their first nonpathological, low-energy hip fracture surgery at an Asian tertiary hospital from June 2007 to 2012. Patients were identified as cases with ESRF on dialysis (study group) or non-ESRF patients (controls). Various comorbidity factors and postoperative 1-year mortality status were obtained from institutional electronic medical records. Univariate and multivariate logistic regression were used to identify significant risk factors for all-cause, 1-year mortality. Results: With no loss to follow-up, the 1-year postoperative mortality rate was 19.6% for the 46 patients with ESRF on dialysis and 8.4% for non-ESRF controls ( P = .028). Fisher exact test showed that hypertension, ischemic heart disease (IHD), diabetes mellitus (DM), anemia, cerebrovascular disease, and vascular disease were significantly associated with ESRF ( P < .05). Multivariable logistic regression analysis identified ESRF (adjusted odds ratio[AOR] = 2.85, P = .021), cancer (AOR = 3.04, P = .003), IHD (AOR = 2.07, P = .020), DM (AOR = 2.03, P = .022), and age (AOR = 1.08, P <.0001) as independent risk factors for 1-year mortality following hip fracture surgery. The area under the receiver–operating characteristic curve (95% confidence interval) for the multivariable predictor of 1-year mortality was 0.75 (0.60-0.82). Conclusions: Although associated with multiple comorbidities, ESRF was found to be independently predictive of 1-year mortality in patients undergoing hip fracture surgery, second to cancer in terms of magnitude of risk posed. As ESRF is a negative prognostic factor for 1-year mortality after hip fracture surgery, its importance should be recognized with implications on preoperative counseling to patients about the increased risk and implications on fracture prevention.

Risk Factors for Falls in People With a Lower Limb Amputation: A Systematic Review

PM&R ◽  
2016 ◽  
Vol 9 (2) ◽  
pp. 170-180.e1 ◽  
Author(s):  
Susan W. Hunter ◽  
Frances Batchelor ◽  
Keith D. Hill ◽  
Anne-Marie Hill ◽  
Shylie Mackintosh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Risk Factors For Falls

scholarly journals Prevalence and Risk Factors for Diabetic Lower Limb Amputation: A Clinic-Based Case Control Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Beverly T. Rodrigues ◽  
Venkat N. Vangaveti ◽  
Usman H. Malabu
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Indigenous Australians ◽  
Haemoglobin A1c ◽  
Foot Clinic

Objective.The aim of the study was to evaluate the prevalence of and risk factors for lower limb amputation in a specialist foot clinic-based setting.Methods.A retrospective quantitative study was conducted, using clinical and biochemical profiles of diabetic foot patients attending the High Risk Foot Clinic at The Townsville Hospital, Australia, between January 1, 2011, and December 31, 2013.Results.The total study sample included 129 subjects, comprising 81 males and 48 females with M : F ratio of 1.7 : 1. Twenty-three subjects were Indigenous Australians, representing 17.8% of the study population. The average age of the cohort was 63.4 years ± 14.1 years [CI 90.98–65.89]. Lower limb amputation was identified as a common and significant outcome (n=44), occurring in 34.1%, more commonly amongst the Indigenous Australians (56.5% versus 29.2%;p=0.94, OR 0.94). Risk factors most closely associated with amputation included diabetic retinopathy (p=0.00, OR 4.4), coronary artery bypass graft (CABG) surgery (p=0.01, OR 4.1), Charcot’s arthropathy (p=0.01, OR 2.9), and Indigenous ethnicity (p=0.01, OR 3.4). Although average serum creatinine, corrected calcium, and glycosylated haemoglobin A1c (Hba1c) levels were higher amongst amputees they were statistically insignificant.Conclusions.Lower limb amputation is a common outcome and linked to ethnicity and neurovascular diabetic complications amongst subjects with diabetic foot ulcer. Further research is needed to identify why risk of lower limb amputation seems to differ according to ethnicity.

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