Observational studyBMC nephrology2019
Risk factors for foot ulceration in adults with end-stage renal disease on dialysis: a prospective observational cohort study.
Observational study in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Diabetic Foot Ulceration in Dialysis-Dependent End-Stage Kidney Disease: A Systematic Review of Epidemiology, Clinical Outcomes and Mortality Risk.Diabetes/metabolism research and reviews · 2026Pooled it
- Risk Factors for Foot-Related Hospitalisations in Adults With and Without Diabetes: A Systematic Review.Journal of foot and ankle research · 2026Pooled it
- Risk factors and a predictive model of diabetic foot in hospitalized patients with type 2 diabetes.World journal of diabetes · 2025Article
- A tool to predict the risk of lower extremity amputation in patients starting dialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Article
- The burden of costs on health services by patients with neuro-ischaemic ulcers in Singapore.International wound journal · 2023Article
- Risks and outcomes of critical limb ischemia in hemodialysis patients: a prospective cohort study.Clinical kidney journal · 2023Article
- The Relationship Between Bone Metabolism and Peripheral Artery Disease in Patients on Hemodialysis: The Potential Role of Osteocalcin.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Narrative Review of the Relationship Between CKD and Diabetic Foot Ulcer.Kidney international reports · 2022Review
- Micro- and macrovascular complications and risk factors for foot ulceration and amputation in individuals receiving dialysis with and without diabetes.Endocrinology, diabetes & metabolism · 2022Article
- Lower Limb Ulcer Associated with Peritonitis in Patients Undergoing Peritoneal Dialysis.International journal of nephrology and renovascular disease · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDialysis patients experience high rates of foot ulceration. Although risk factors for ulceration have been extensively studied in patients with diabetes, there is limited high-quality, longitudinal evidence in the dialysis population. Therefore, this study investigated risk factors for foot ulceration in a stable dialysis cohort.
methodsWe prospectively collected clinical, demographic, health status, and foot examination information on 450 adults with end-stage renal disease from satellite and home-therapy dialysis units in Melbourne, Australia over 12 months. The primary outcome was foot ulceration. Cox proportional hazard modelling and multinomial regression were used to investigate risk factors.
resultsAmong 450 dialysis patients (mean age, 67.5 years; 64.7% male; 94% hemodialysis; 50.2% diabetes), new cases of foot ulceration were identified in 81 (18%) participants. Overall, risk factors for foot ulceration were neuropathy (HR 3.02; 95% CI 1.48 to 6.15) and previous ulceration (HR 2.86; CI 1.53 to 5.34). In those without history of ulceration, nail pathology (RR 3.85; CI 1.08 to 13.75) and neuropathy (RR 2.66; CI 1.04 to 6.82) were risk factors. In those with history of ulceration, neuropathy (RR 11.23; CI 3.16 to 39.87), peripheral arterial disease (RR 7.15; CI 2.24 to 22.82) and cerebrovascular disease (RR 2.08; CI 1.04 to 4.16) were risk factors. There were 12 (2.7%) new amputations, 96 (21.3%) infections, 24 (5.3%) revascularizations, 42 (9.3%) foot-related hospitalizations, and 52 (11.6%) deaths.
conclusionsNeuropathy and previous ulceration are major risk factors for foot ulceration in dialysis patients. Risk factors differ between those with and without prior ulceration. The risk factors identified will help to reduce the incidence of ulceration and its associated complications.
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