Factors associated with foot ulceration and amputation in adults on dialysis: a cross-sectional observational study

Table 2 Foot examination, foot-health care behaviors and podiatry attendance – data are n (%), unless otherwise specified

		Foot ulceration			Lower extremity amputation
	Total (N = 450)	Yes (n = 45)	No (n = 405)	P-value*	Yes (n = 46)	No (n = 404)	P-value*
Peripheral neuropathy^a	228 (50.7)	43 (95.6)	185 (45.7)	<0.001*	44 (95.7)	184 (45.5)	<0.001*
Peripheral arterial disease^b	236 (52.4)	42 (93.3)	194 (47.9)	<0.001*	39 (84.8)	197 (48.8)	<0.001*
Arterial calcification	184 (40.9)	20 (44.4)	164 (40.5)	0.73	21 (45.7)	163 (40.3)	0.592
Foot deformity	341 (75.8)	39 (86.7)	302 (74.6)	0.107	42 (91.3)	299 (74.0)	0.016*
Limited range of motion of first MTPJ^c	421 (93.6)	39 (86.7)	382 (94.3)	0.29	38 (82.6)	383 (94.8)	0.30
Median peak plantar pressure (IQR), kg/cm ^2c
Total left foot^d	1.74 (1.50 to 2.06)	2.00 (1.74 to 2.40)	1.73 (1.50 to 2.04)	0.007*	2.02 (1.76 to 2.36)	1.73 (1.50 to 2.03)	0.002*
Total right foot^d	1.72 (1.50 to 2.09)	2.11 (1.68 to 2.42)	1.71 (1.49 to 2.05)	0.002*	2.09 (1.80 to 2.42)	1.71 (1.49 to 2.05)	0.001*
Skin pathology	395 (87.8)	42 (93.3)	353 (87.2)	0.34	43 (93.5)	352 (87.1)	0.31
Nail pathology	319 (70.9)	37 (82.2)	282 (69.6)	0.112	34 (73.9)	285 (70.5)	0.76
Inappropriate footwear	297 (66.0)	25 (55.6)	272 (67.2)	0.164	21 (45.7)	276 (68.3)	0.004*
Poor foot-health care	136 (30.2)	10 (22.2)	126 (31.1)	0.289	7 (15.2)	129 (31.9)	0.030*
Podiatry attendance, last 12 months	223 (49.6)	36 (80.0)	187 (46.2)	<0.001*	36 (78.3)	187 (46.3)	<0.001*

*Significant difference between ‘foot ulceration/amputation’ and ‘no foot ulceration/amputation’ groups, p < 0.05. MTPJ Metatarsophalangeal joint. ^aPeripheral neuropathy was defined as documentation of known peripheral neuropathy in the medical records; monofilament score < 3/3 (either foot); and/or vibration perception threshold >25 V (either foot). ^bPeripheral arterial disease was defined as documentation of known peripheral arterial disease in the medical records and/or history of lower extremity revascularization procedure; absence of ≥2 pedal pulses; toe-brachial pressure index ≤0.6 (either foot); and/or ankle-brachial pressure index ≤0.9. ^cMaximum missing data were for left peak plantar pressure involving 56 participants overall (12.4%). Missing data were for limited range of motion of first MTPJ (left, n = 25; right, n = 15) and peak plantar pressures (left, n = 56; right, n = 55). ^dData presented are of the total foot and do not include any specific regions (e.g. hallux, 1st MTPJ, etc.). IQR Interquartile range

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