Variability of Toe Pressures During Haemodialysis: Comparison of People With and Without Diabetes; a Pilot Study

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aut.relation.articlenumber42
aut.relation.journalJournal of Foot and Ankle Research
aut.relation.volume16
dc.contributor.authorCarle, Rachel
dc.contributor.authorTehan, Peta
dc.contributor.authorStewart, Sarah
dc.contributor.authorSemple, David
dc.contributor.authorPilmore, Andrew
dc.contributor.authorCarroll, Matthew
dc.date.accessioned2023-07-11T02:31:27Z
dc.date.available2023-07-11T02:31:27Z
dc.date.issued2023-07-10
dc.description.abstractBackground Diabetes, end stage renal disease (ESRD), and peripheral arterial disease (PAD) are associated with a higher risk of diabetes-related lower limb amputation. Timely identification of PAD with toe systolic blood pressure (TSBP) and toe-brachial pressure index (TBPI) is critical in order to implement foot protection strategies to prevent foot complications in people with ESRD. There is limited evidence describing the effect of haemodialysis on TSBP and TBPI. This study aimed to determine the variability of TSBP and TBPI during haemodialysis in people with ESRD, and to determine whether any observed variability differed between people with and without diabetes. Methods TSBP and TBPI were taken before dialysis (T1), one hour into dialysis (T2) and in the last 15 min of dialysis (T3) during a single dialysis session. Linear mixed effects models were undertaken to determine the variability in TSBP and TBPI across the three time points and to determine whether this variability differed between people with and without diabetes. Results Thirty participants were recruited, including 17 (57%) with diabetes and 13 (43%) with no diabetes. A significant overall reduction in TSBP was observed across all participants (P < 0.001). There was a significant reduction in TSBP between T1 and T2 (P < 0.001) and between T1 and T3 (P < 0.001). There was no significant overall change in TBPI over time (P = 0.62). There was no significant overall difference in TSBP between people with diabetes and people with no diabetes (mean difference [95% CI]: -9.28 [-40.20, 21.64], P = 0.54). There was no significant overall difference in TBPI between people with diabetes and people with no diabetes (mean difference [95% CI]: -0.01 [-0.17, 03.16], P = 0.91). Conclusion TSBP and TBPI are an essential part of vascular assessment of the lower limb. TBPI remained stable and TSBP significantly reduced during dialysis. Given the frequency and duration of dialysis, clinicians taking toe pressures to screen for PAD should be aware of this reduction and consider how this may have an impact on wound healing capacity and the development of foot related complications.
dc.identifier.citationJournal of Foot and Ankle Research, ISSN: 1757-1146 (Print), BMC, 16. doi: 10.1186/s13047-023-00642-y
dc.identifier.doi10.1186/s13047-023-00642-y
dc.identifier.issn1757-1146
dc.identifier.urihttp://hdl.handle.net/10292/16417
dc.languageEnglish
dc.publisherBMC
dc.relation.urihttps://jfootankleres.biomedcentral.com/articles/10.1186/s13047-023-00642-y
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectToe pressures
dc.subjectHaemodialysis
dc.subjectDiabetes
dc.subject1103 Clinical Sciences
dc.subject1104 Complementary and Alternative Medicine
dc.subject1106 Human Movement and Sports Sciences
dc.subject3202 Clinical sciences
dc.subject4201 Allied health and rehabilitation science
dc.subject4207 Sports science and exercise
dc.titleVariability of Toe Pressures During Haemodialysis: Comparison of People With and Without Diabetes; a Pilot Study
dc.typeJournal Article
pubs.elements-id512890
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