Foot and Ankle Care by Podiatrists and Amputations in Patients With Diabetes and Kidney Failure
Authors' conclusion
The findings of this study suggest that patients with kidney failure at risk for DFUs who receive foot and ankle care from podiatrists may be associated with a reduced likelihood of diabetes-related amputations.
Study context
- Population
- Medicare beneficiaries with T2D receiving dialysis with a new DFU diagnosis, United States Renal Data System 2016–2019; mean age 59.3 years
- Participants
- 14,935 beneficiaries
- Exposure
- Foot and ankle care by podiatrists vs none in the 3 months before DFU diagnosis
- Podiatric caren = 2,736
- Outcome
- Composite of:
- Death and/or major amputation
- Major amputation alone
Methodological detailsinverse probability-weighted Cox regression, competing risk regression
- Inverse probability-weighted Cox regression
- Competing risk regression
Main finding
As reported in the abstract
Death and/or major amputation (composite) · mean (SD) 13.5 (12.0)-month follow-up
- Foot and ankle care by podiatrists vs no such care, death and/or amputation: HR
- 0.89 (0.84-0.93) (95% CI)
- Lower likelihood of death and/or amputation with foot and ankle care
- 11%
Observational data: associations, not effects.
Further findings
Major amputation (above or below knee)
- Foot and ankle care by podiatrists vs no such care, major amputation: HR
- 0.91 (0.84-0.99) (95% CI)
- Lower likelihood of major amputation with foot and ankle care
- 9%
- Multivariate regression analysis (competing risk regression)
Survival probability · 36 months
- Survival probabilities at 36 months, podiatric care vs nonpodiatric
- 26.3% vs 22.8% (P < .001)
- Unadjusted Kaplan-Meier survival analysis
Original publication
Foot and Ankle Care by Podiatrists and Amputations in Patients With Diabetes and Kidney Failure. JAMA Netw Open. Published 1 March 2024. doi:10.
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