Background: Lower limb ischemia affects the quality of life, physical activity and life expectancy of dialysis patients. The aim of this study was to investigate the risk factors associated with ischemic foot ulcers considering clinical, laboratory and therapeutic domains.
Methods: This observational cohort study was based on data from the Nephrology and Dialysis Department database of Alessandro Manzoni Hospital, Lecco (Italy). All of the incident patients who started dialysis between 1 January 1999 and 29 February 2012 were enrolled, excluding temporary guests, patients with acute renal failure and patients with previous limb ischemia or amputation. Multivariate Cox regression analysis identified the predictors in each domain, which were matched in the final model. A time-dependent approach was used to take into account the evolution of some of the prognostic covariates.
Results: Of the 526 incident dialysis patients, 120 developed a lower limb ischemic lesion after a median of 13 months. The incidence of new ulcers was constant during the study period (6 per 100 person-years), but higher in the diabetics with a relative rate of 4.5. The variables significantly related to an increased risk of lower limb ulcers were age, male gender, diabetes, ischemic heart disease, treatment with proton pump inhibitors, iron, anticoagulants and calcium-based binders, and blood levels of phosphorus, triglycerides and C-reactive protein.
Conclusion: The incidence of lower limb ulcers was highest during the early dialysis follow-up and was associated with, in addition to diabetes, modifiable laboratory and therapeutic predictors such as anticoagulants, proton pump inhibitors, calcium-containing binders, calcimimetics and iron.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s40620-017-0429-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Tranexamic acid in hip and spine surgery for children with cerebral palsy - a PRISMA-compliant scoping review.
Syst Rev
December 2024
Department of Paediatrics, The Royal Children's Hospital, University of Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia.
Many children with cerebral palsy (CP) are frail and require major hip and/or spine surgeries associated with substantial blood loss. Tranexamic acid (TXA) is commonly used to reduce blood loss, but there is uncertainty around the optimal dose and timing of administration. There have been reviews in sub-populations and specific dosing regimens, but a broad overview of the available literature is lacking.
View Article and Find Full Text PDFFully-automated segmentation of muscle and inter-/intra-muscular fat from magnetic resonance images of calves and thighs: an open-source workflow in Python.
Skelet Muscle
December 2024
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
Background: INTER- and INTRAmuscular fat (IMF) is elevated in high metabolic states and can promote inflammation. While magnetic resonance imaging (MRI) excels in depicting IMF, the lack of reproducible tools prevents the ability to measure change and track intervention success.
Methods: We detail an open-source fully-automated iterative threshold-seeking algorithm (ITSA) for segmenting IMF from T1-weighted MRI of the calf and thigh within three cohorts (CaMos Hamilton (N = 54), AMBERS (N = 280), OAI (N = 105)) selecting adults 45-85 years of age.
Portions of the force-velocity relationship targeted by weightlifting exercises.
Sci Rep
December 2024
Faculty of Sport Sciences, Waseda University, Saitama, 359-1192, Japan.
We compared the force-velocity (F-V) characteristics between jump squat (JS) and weightlifting (hang clean [HC] and HC pull [HCP]) to determine lower limb F-V portions targeted by weightlifting exercises. Ten weightlifters performed JS at 0% (body weight only) to 70% of their one-repetition maximum (1RM) for back squat, and HC and HCP at 30‒90% and 30‒110% of their 1RM for HC, respectively. Force and velocity values at each relative load were plotted to determine the F-V features of JS, HC, and HCP.
View Article and Find Full Text PDFPostnatal foot length measurement as a proxy to identify low birth weight for frontline health workers in rural Sindh Province, Pakistan: a diagnostic accuracy study.
BMJ Open
December 2024
Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Objective: To assess the diagnostic accuracy of postnatal foot length (FL) measurements as a proxy to identify low birth weight (LBW) for frontline healthcare workers in rural Sindh Province, Pakistan.
Design: A community-based cross-sectional study.
Setting: This study was conducted in the catchment area of Global Network's Maternal and Newborn Health Registry, Thatta, Sindh Province, Pakistan, from January to June 2023.
A Combined "Vasculoplastic" Approach to the Vasculopathic Patient Undergoing Limb Salvage: Understanding the Role of Endovascular Revascularization for Lower Extremity Free Tissue Transfer.
J Reconstr Microsurg
December 2024
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia.
Background: Multidisciplinary care with vascular surgery and plastic surgery is essential for lower extremity free flap (LEFF) success in the chronic wound population with diabetes and peripheral vascular disease. There is a lack of understanding on performing targeted direct endovascular reperfusion on a vessel that will be used as the flap recipient. Our study compares outcomes of patients who received targeted revascularization (TR) to the recipient vessel for LEFF anastomosis versus nontargeted revascularization (NR) of arterial recipients prior to LEFF.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!