American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 680-692 , October 2009

The Burden of Amputation Among Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

  • Christian Combe, MD, PhD

      Affiliations

    • Service de Néphrologie, Centre Hospitalier Universitaire de Bordeaux; Unité INSERM U889; Université Bordeaux 2 Victor Segalen, Bordeaux, France
    • ,
  • Justin M. Albert, BA

      Affiliations

    • Arbor Research Collaborative for Health, Ann Arbor, MI
    • ,
  • Jennifer L. Bragg-Gresham, MS

      Affiliations

    • Arbor Research Collaborative for Health, Ann Arbor, MI
    • ,
  • Vittorio E. Andreucci, MD

      Affiliations

    • Universitá Federico II, Naples, Italy
    • ,
  • Alex Disney, MD

      Affiliations

    • Renal Unit, The Queen Elizabeth Hospital, Woodville, South Australia
    • ,
  • Shunichi Fukuhara, MD

      Affiliations

    • Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
    • ,
  • David A. Goodkin, MD

      Affiliations

    • Arbor Research Collaborative for Health, Ann Arbor, MI
    • ,
  • Brenda W. Gillespie, PhD

      Affiliations

    • Department of Biostatistics, University of Michigan, Ann Arbor, MI
    • ,
  • Akira Saito, MD

      Affiliations

    • School of Medicine, Tokai University, Kanagawa, Japan
    • ,
  • Michel Jadoul, MD

      Affiliations

    • Renal Unit, Cliniques Universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
    • ,
  • Ronald L. Pisoni, PhD

      Affiliations

    • Arbor Research Collaborative for Health, Ann Arbor, MI
    • Corresponding Author InformationAddress correspondence to Ronald L. Pisoni, PhD, Arbor Research Collaborative for Health, Ann Arbor, MI 48103

Received 18 November 2008 ,Accepted 15 April 2009.

References 

  1. Port FK. Morbidity and mortality in dialysis patients. Kidney Int. 1994;46:1728–1737
  2. Luke RG. Chronic renal failure—A vasculopathic state. N Engl J Med. 1998;339:841–843
  3. Jaar BG, Astor BC, Berns JS, Powe NR. Predictors of amputation and survival following lower extremity revascularization in hemodialysis patients. Kidney Int. 2004;65:613–620
  4. O'Hare AM, Bacchetti P, Segal M, Hsu CY, Johansen KL. Factors associated with future amputation among patients undergoing hemodialysis: Results from the Dialysis Morbidity and Mortality Study Waves 3 and 4. Am J Kidney Dis. 2003;41:162–170
  5. O'Hare AM, Glidden DV, Fox CS, Hsu CY. High prevalence of peripheral arterial disease in persons with renal insufficiency: Results from the National Health and Nutrition Examination Survey 1999-2000. Circulation. 2004;109:320–323
  6. Eggers PW, Gohdes D, Pugh J. Nontraumatic lower extremity amputations in the Medicare end-stage renal disease population. Kidney Int. 1999;56:1524–1533
  7. Speckman RA, Frankenfield DL, Roman SH, et al. Diabetes is the strongest risk factor for lower-extremity amputation in new hemodialysis patients. Diabetes Care. 2004;27:2198–2203
  8. O'Hare AM. Management of peripheral arterial disease in chronic kidney disease. Cardiol Clin. 2005;23:225–236
  9. Sanchez Perales MC, Garcia Cortes MJ, Borrego Utiel FJ, et al. Incidencia y factores de riesgo de amputacion no traumatica de miembros inferiores en los pacientes en hemodialisis. Nefrologia. 2005;25:399–406
  10. The Global Lower Extremity Amputation Study Group. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. Br J Surg. 2000;87:328–337
  11. Ephraim PL, Dillingham TR, Sector M, Pezzin LE, Mackenzie EJ. Epidemiology of limb loss and congenital limb deficiency: A review of the literature. Arch Phys Med Rehabil. 2003;84:747–761
  12. Wrobel JS, Mayfield JA, Reiber GE. Geographic variation of lower-extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care. 2001;24:860–864
  13. Toursarkissian B, Shireman PK, Harrison A, D'Ayala M, Schoolfield J, Sykes MT. Major lower-extremity amputation: Contemporary experience in a single Veterans Affairs institution. Am Surg. 2002;68:606–610
  14. Young EW, Goodkin DA, Mapes DL, et al. The Dialysis Outcomes and Practice Patterns Study (DOPPS): An international hemodialysis study. Kidney Int Suppl. 2000;57:S74–S81
  15. Rajagopalan S, Dellegrottaglie S, Furniss AL, et al. Peripheral arterial disease in patients with end-stage renal disease: Observations from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Circulation. 2006;114:1914–1922
  16. Portale A. Blood calcium, phosphorus, and magnesium. In:  Favus M editors. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Philadelphia, PA: Lippincott, Williams & Wilkins; 1999;p. 115–118
  17. Levine MP. The hemodialysis patient and hand amputation. Am J Nephrol. 2001;21:498–501
  18. Yeager RA, Moneta GL, Edwards JM, et al. Relationship of hemodialysis access to finger gangrene in patients with end-stage renal disease. discussion, 9 J Vasc Surg. 2002;36:245–249
  19. Goodkin DA, Bragg-Gresham JL, Koenig KG, et al. Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: The Dialysis Outcomes and Practice Patterns Study (DOPPS). J Am Soc Nephrol. 2003;14:3270–3277
  20. Rayner HC, Pisoni RL, Bommer J, et al. Mortality and hospitalization in haemodialysis patients in five European countries: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2004;19:108–120
  21. Jeffcoate WJ, van Houtum WH. Amputation as a marker of the quality of foot care in diabetes. Diabetologia. 2004;47:2051–2058
  22. Cheung AK, Sarnak MJ, Yan G, et al. Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney Int. 2000;58:353–362
  23. O'Hare AM, Hsu CY, Bacchetti P, Johansen KL. Peripheral vascular disease risk factors among patients undergoing hemodialysis. J Am Soc Nephrol. 2002;13:497–503
  24. Leskinen Y, Salenius JP, Lehtimaki T, Huhtala H, Saha H. The prevalence of peripheral arterial disease and medial arterial calcification in patients with chronic renal failure: Requirements for diagnostics. Am J Kidney Dis. 2002;40:472–479
  25. O'Hare A, Johansen K. Lower-extremity peripheral arterial disease among patients with end-stage renal disease. J Am Soc Nephrol. 2001;12:2838–2847
  26. O'Hare AM, Johansen KL. Peripheral vascular disease in end-stage renal disease patients. Int J Artif Organs. 2002;25:1123–1127
  27. O'Hare AM, Katz R, Shlipak MG, Cushman M, Newman AB. Mortality and cardiovascular risk across the ankle-arm index spectrum: Results from the Cardiovascular Health Study. Circulation. 2006;113:388–393
  28. O'Hare AM, Newman AB, Katz R, et al. Cystatin C and incident peripheral arterial disease events in the elderly: Results from the Cardiovascular Health Study. Arch Intern Med. 2005;165:2666–2670
  29. O'Hare AM, Vittinghoff E, Hsia J, Shlipak MG. Renal insufficiency and the risk of lower extremity peripheral arterial disease: Results from the Heart and Estrogen/Progestin Replacement Study (HERS). J Am Soc Nephrol. 2004;15:1046–1051
  30. Schmieder FA, Comerota AJ. Intermittent claudication: Magnitude of the problem, patient evaluation, and therapeutic strategies. Am J Cardiol. 2001;87(suppl D):S3D–S13D
  31. Murabito JM, D'Agostino RB, Silbershatz H, Wilson WF. Intermittent claudication (A risk profile from the Framingham Heart Study). Circulation. 1997;96:44–49
  32. Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int. 2003;63:793–808
  33. Agarwal R. Hypertension and survival in chronic hemodialysis patients—Past lessons and future opportunities. Kidney Int. 2005;67:1–13
  34. Bhatt DL, Steg PG, Ohman EM, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295:180–189
  35. Miyajima S, Shirai A, Yamamoto S, Okada N, Matsushita T. Risk factors for major limb amputations in diabetic foot gangrene patients. Diabetes Res Clin Pract. 2006;71:272–279
  36. Wattanakit K, Folsom AR, Selvin E, et al. Risk factors for peripheral arterial disease incidence in persons with diabetes: The Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis. 2005;180:389–397
  37. McGrath NM, Curran BA. Recent commencement of dialysis is a risk factor for lower-extremity amputation in a high-risk diabetic population. Diabetes Care. 2000;23:432–433
  38. Goodman WG, Goldin J, Kuizon BD, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med. 2000;342:1478–1483
  39. O'Hare AM, Feinglass J, Reiber GE, et al. Postoperative mortality after nontraumatic lower extremity amputation in patients with renal insufficiency. J Am Soc Nephrol. 2004;15:427–434

 Originally published online as doi: 10.1053/j.ajkd.2009.04.035 on July 21, 2009.

PII: S0272-6386(09)00771-9

doi: 10.1053/j.ajkd.2009.04.035

American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 680-692 , October 2009

Article Tools

* Image Usage & Resolution