Results of lower extremity amputations in patients with end-stage renal disease

J Vasc Surg. 1994 Jul;20(1):14-9. doi: 10.1016/0741-5214(94)90170-8.

Abstract

Purpose: The purpose of this study was to determine the impact of end-stage renal disease (ESRD) on the outcome of patients undergoing lower extremity (LE) amputation.

Methods: Hospital charts and vascular surgery registry data were reviewed for all patients who underwent LE amputation over a consecutive 56-month period. The results of 84 patients with ESRD (137 amputations) were compared with 375 patients (442 amputations) without ESRD.

Results: Hospital mortality rate was significantly greater in patients with ESRD than patients without ESRD, 24% versus 7% (p = 0.001). Patients with ESRD undergoing minor amputations had mortality rates three times greater than patients without ESRD undergoing major LE amputations. In patients with ESRD requiring bilateral or unilateral above-knee amputation hospital mortality rates were 43% and 38%, respectively. In addition, patients with ESRD were seven times more likely to undergo bilateral amputation than patients without ESRD over a mean follow-up period of 17 months. No kidney transplant patients died after amputation.

Conclusion: ESRD has a profound negative impact on morbidity, mortality, and survival rates after LE amputation. Attempts at prevention of amputation with aggressive foot care and patient education in this high-risk group should be the focus of therapy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation*
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / surgery*
  • Female
  • Hospital Mortality
  • Humans
  • Ischemia / complications
  • Ischemia / surgery*
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation
  • Leg / blood supply*
  • Leg / surgery
  • Male
  • Middle Aged
  • Postoperative Complications
  • Renal Dialysis
  • Retrospective Studies