Review of amputations in patients with end-stage renal failure on haemodialysis at the Townsville Hospital

Background / Aims: High rates of end stage renal failure (ESRF) have been reported in North Queensland. Furthermore haemodialysis has recently been identified as a risk factor for lower limb amputations. In spite of these no study has been published that analyses the magnitude and risk factors for amputation amongst haemodialysis patients. This study aims to document trends in prevalence and identify risk factors of non-traumatic lower limb amputations in subjects treated with haemodialysis in North Queensland. Methods: 102 current haemodialysis patients attending the Townsville Dialysis Centre were included in the study. Odds ratio and #967;2 tests were performed to identify variables most strongly associated with amputation. Results: We identified a 6.9% prevalence of lower limb amputation in 102 subjects on haemodialysis at our centre. The major risk factors of amputations in the cohort were history of ulceration (RR 4.57 [95%Cl 2.4-8.8] p=0.001) and the presence of diabetes (RR 2.5 [95%Cl 1.6-3.9] p=0.008). Other variables were tested but fell short of statistical significance, these included: Indigenous background, smoking history, gender and type of ulceration. Conclusion: Patients with ESRF on haemodialysis who have a past history of ulceration and have diabetes mellitus are at risk of having lower limb amputations. Primary prevention of diabetes in the sub-population may help in reducing the limb loss. Further prospective studies on a larger population are needed to confirm our findings.

Annals of the Australasian College of Tropical Medicine Inc

Annals of the Australasian College of Tropical Medicine

14

1448-4706

N/A

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