Prevalence of risk factors predisposing to foot problems in patients on hemodialysis

The prevalence of peripheral arterial occlusive disease (PAOD) in the general public is estimated at 3.5% to 23% (O'Hare & Johansen, 2001). Among individuals with diabetes, the prevalence of PAOD is four to seven times greater than in those without diabetes (Armstrong, Lavery, & Harkless, 1998). The most common cause of chronic renal failure is diabetes, accounting for 44.3% of new end stage renal disease (ESRD) patients annually in the United States (U.S.) and 33% of new ESRD patients in Canada (U.S. Renal Data Systems [USRDS], 2003).

Annually more than 125,000 people in the U.S. undergo lower extremity amputations (Armstrong et al., 1998). Of these, between 50% and 80% are attributable to diabetes (Lavery et al., 1996; Spollett, 1998). There is some evidence to suggest that the prevalence of foot problems among patients with diabetes who also have ESRD is even greater than in patients with diabetes without ESRD (Eggers, Gohdes, & Pugh, 1999; Hill et al., 1996; Rith-Najariah & Gohdes, 2000). Thus, the potential burden of illness in a dialysis population is a costly one. According to some sources, however, between 50% and 85% of lower extremity amputations associated with diabetes could be avoided or delayed through appropriate educational and treatment programs (Edmonds, 1987; Halpin-Landry & Goldsmith, 1999).

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