Nutrició i Malaltia Renal

Objectius del nostre grup de treball - Nutrició i Malaltia Renal

El grup d'hemodiàlisi, realitzarem un estudi multicèntric. Amb la col·laboració del centre de diàlisi Diaverum - Maresme, unitats d'hemodiàlisi de l'Hospital del Mar i la Fundació Puigvert. Estudiarem la relació de suport sociofamiliar en els malalts crònics, en tractament d'hemodiàlisi i l'adhesió terapèutica. 

Mitjançant qüestionaris de salut autopercebuda, de suport social, dinàmica familiar i situació de risc social. Ja que la cronicitat produeix diverses psicopatologies (depressió i ansietat) i precisa d'un bon suport emocional i social per a una adaptació a la malaltia crònica.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848423/

 

Abstract

Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.