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Related Experiment Videos

Lower extremity amputations in chronically dialysed patients: a 10 year study.

Asher Korzets1, Yaacov Ori, Mauro Rathaus

  • 1Institute of Nephrology and Hypertension, Rabin Medical Center (Golda Campus), Petah Tiqva, Israel.

The Israel Medical Association Journal : IMAJ
|August 7, 2003
PubMed
Summary

Critical limb ischemia in dialysis patients often requires amputation. Early revascularization or primary amputation, followed by prosthetic rehabilitation, improves outcomes for these complex patients.

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Rehabilitation Medicine

Background:

  • Lower limb critical ischemia presents a significant challenge for patients undergoing dialysis.
  • Dialysis patients often have widespread arterial calcification, complicating diagnosis and treatment.
  • Amputation rates are substantial within the dialysis population.

Purpose of the Study:

  • To assess the effectiveness of revascularization procedures, amputations, and prosthetic rehabilitation in patients with end-stage renal disease requiring dialysis.
  • To identify factors influencing successful prosthetic rehabilitation in dialyzed amputees.

Main Methods:

  • Retrospective analysis of medical records for dialysis patients who underwent major amputation or entered a rehabilitation program.
  • Evaluation of revascularization outcomes, amputation levels, and prosthetic rehabilitation success rates.

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  • Comparison of outcomes between dialyzed amputees and non-uremic amputees.

    • Main Results:

    • Prosthetic rehabilitation was successful in 12 patients, partially successful in 8, and failed in 4, with failed rehabilitation correlating with shorter survival.
    • Younger age and primary amputation were associated with better rehabilitation outcomes.
    • Dialyzed amputees showed similar rehabilitation results to non-uremic amputees, but with longer hospitalization.

    Conclusions:

    • Prompt, definitive treatment is crucial for critical limb ischemia in dialysis patients.
    • Revascularization should be considered when feasible after diagnostic angiography.
    • Primary amputation is recommended for extensive foot infections or gangrene, and prosthetic rehabilitation is generally indicated.