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Comparison of the risk of non-traumatic lower extremity amputation between haemodialysis and peritoneal dialysis patients with end-stage renal disease.
Nephrology (Carlton). 2018 Jan; 23(1):86-92.N

Abstract

AIM

We used insurance claims data of Taiwan to compare the risk of non-traumatic lower extremity amputation between haemodialysis (HD) and peritoneal dialysis (PD) patients.

METHODS

We identified 77 669 HD patients and 10 035 PD patients without prior amputation from 2000 to 2010. Incidence rates and hazard ratios (HRs) of lower extremity amputation, and subsequent 30-day mortality after amputation were evaluated up to 31 December 2011.

RESULTS

There were 2427 and 216 patients undergoing lower extremity amputation during follow-up in the HD and PD groups with incidence rates of 8.35 and 5.79 per 1000 person-years, respectively. Compared with the HD group, the overall adjusted HR of lower extremity amputation for the PD group was 1.27 (95% CI = 1.10-1.46). The impact of diabetes status on the risk of lower extremity amputation interacted with dialysis modality significantly (P < 0.001). Compared with the corresponding HD patients, the PD patients with diabetes had an adjusted HR of 1.44 (95% CI = 1.24-1.67) for amputation, whereas those without diabetes had an adjusted HR of 0.58 (95% CI = 0.36-0.95). The subsequent 30-day mortality rates after amputation were not significantly different between the HD and PD groups (8.45% vs. 9.72%) with an adjusted odds ratio of 1.41 (95% CI = 0.87-2.28, PD versus HD).

CONCLUSION

Compared with corresponding HD patients, the amputation risk is higher for PD patients with diabetes, while the risk is lower for PD patients without diabetes. Dialysis patients have a high 30-day mortality risk after amputation.

Authors+Show Affiliations

Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan. Department of Internal Medicine, China Medical University College of Medicine, Taichung, Taiwan. Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.Division of Cardiology, China Medical University Hospital, Taichung, Taiwan.Department of Orthopedic Surgery, China Medical University and Hospital, Taichung, Taiwan.Division of Cardiology, China Medical University Hospital, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan. Chang Gung University College of Medicine, Taoyuan, Taiwan.Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.Division of Nephrology, Yun-Lin Branch, National Taiwan University Hospital, Yun-Lin, Taiwan.Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. Department of Health Services Administration, China Medical University, Taichung, Taiwan.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27723258

Citation

Wang, I-Kuan, et al. "Comparison of the Risk of Non-traumatic Lower Extremity Amputation Between Haemodialysis and Peritoneal Dialysis Patients With End-stage Renal Disease." Nephrology (Carlton, Vic.), vol. 23, no. 1, 2018, pp. 86-92.
Wang IK, Hsu CH, Tsai CH, et al. Comparison of the risk of non-traumatic lower extremity amputation between haemodialysis and peritoneal dialysis patients with end-stage renal disease. Nephrology (Carlton). 2018;23(1):86-92.
Wang, I. K., Hsu, C. H., Tsai, C. H., Chang, S. S., Lin, C. L., Yen, T. H., Lin, S. Y., Lin, C. C., Liu, J. H., Chang, C. T., & Sung, F. C. (2018). Comparison of the risk of non-traumatic lower extremity amputation between haemodialysis and peritoneal dialysis patients with end-stage renal disease. Nephrology (Carlton, Vic.), 23(1), 86-92. https://doi.org/10.1111/nep.12946
Wang IK, et al. Comparison of the Risk of Non-traumatic Lower Extremity Amputation Between Haemodialysis and Peritoneal Dialysis Patients With End-stage Renal Disease. Nephrology (Carlton). 2018;23(1):86-92. PubMed PMID: 27723258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the risk of non-traumatic lower extremity amputation between haemodialysis and peritoneal dialysis patients with end-stage renal disease. AU - Wang,I-Kuan, AU - Hsu,Chung-Ho, AU - Tsai,Chun-Hao, AU - Chang,Shih-Sheng, AU - Lin,Cheng-Li, AU - Yen,Tzung-Hai, AU - Lin,Shih-Yi, AU - Lin,Chung-Chih, AU - Liu,Jiung-Hsiun, AU - Chang,Chiz-Tzung, AU - Sung,Fung-Chang, PY - 2016/04/14/received PY - 2016/10/06/revised PY - 2016/10/06/accepted PY - 2016/10/11/pubmed PY - 2018/8/7/medline PY - 2016/10/11/entrez KW - Amputation KW - and peritoneal dialysis KW - end-stage renal disease KW - haemodialysis KW - mortality SP - 86 EP - 92 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 23 IS - 1 N2 - AIM: We used insurance claims data of Taiwan to compare the risk of non-traumatic lower extremity amputation between haemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: We identified 77 669 HD patients and 10 035 PD patients without prior amputation from 2000 to 2010. Incidence rates and hazard ratios (HRs) of lower extremity amputation, and subsequent 30-day mortality after amputation were evaluated up to 31 December 2011. RESULTS: There were 2427 and 216 patients undergoing lower extremity amputation during follow-up in the HD and PD groups with incidence rates of 8.35 and 5.79 per 1000 person-years, respectively. Compared with the HD group, the overall adjusted HR of lower extremity amputation for the PD group was 1.27 (95% CI = 1.10-1.46). The impact of diabetes status on the risk of lower extremity amputation interacted with dialysis modality significantly (P < 0.001). Compared with the corresponding HD patients, the PD patients with diabetes had an adjusted HR of 1.44 (95% CI = 1.24-1.67) for amputation, whereas those without diabetes had an adjusted HR of 0.58 (95% CI = 0.36-0.95). The subsequent 30-day mortality rates after amputation were not significantly different between the HD and PD groups (8.45% vs. 9.72%) with an adjusted odds ratio of 1.41 (95% CI = 0.87-2.28, PD versus HD). CONCLUSION: Compared with corresponding HD patients, the amputation risk is higher for PD patients with diabetes, while the risk is lower for PD patients without diabetes. Dialysis patients have a high 30-day mortality risk after amputation. SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/27723258/Comparison_of_the_risk_of_non_traumatic_lower_extremity_amputation_between_haemodialysis_and_peritoneal_dialysis_patients_with_end_stage_renal_disease_ L2 - https://doi.org/10.1111/nep.12946 DB - PRIME DP - Unbound Medicine ER -