Worldwide prevalence of lower limb amputation in renal dialysis patients: a systematic review

Background/Aims: Renal dialysis has recently been identified as a risk factor for lower limb amputation (LLA) however, exact rates are not known. Methods: A systematic review of existing literature investigating the prevalence of LLA in subjects that had end-stage renal failure (ESRF) and were on renal dialysis was conducted. A systematic literature search using the MeSH terms 'diabetes' AND 'amputations' AND 'renal dialysis' was conducted in PUBMED, Medline, Cochrane reviews and Google Scholar database for full text articles published in English from July 2003 to July 2013. Results: A total of 6 full text published studies conducted worldwide were included in this systematic review, 5 of which included patients on haemodialysis alone and one on both haemodialysis and peritoneal dialysis. The reported findings on prevalence of amputations in the renal failure cohort varied from 1.72% in Japan to 13.4% in Canada. Five out of the 6 studies identified presence of diabetes mellitus as the leading risk factor for amputation (p<0.05) in renal dialysis patients. Other risk factors identified were: high HbA1c, high c-reactive protein and low serum albumin. Conclusions: This review demonstrates high prevalence of LLAs in patients with ESRF receiving dialysis therapy. It has also identified the closely associated risk factors with the adverse outcome of amputation, the most important one being the presence of diabetes mellitus.

Annals of the Australasian College of Tropical Medicine Inc

Annals of the Australasian College of Tropical Medicine

15

1448-4706

N/A

3

1