Luigi Uccioli, M Meloni, R Gandini L Giurato, E Pampana, V Ruotolo, V Izzo, S Fabiano and C Del Giudice

4^th International Conference on Nephrology & Therapeutics

September 14-16, 2015 Baltimore, USA

Tor Vergata University, Italy

Tor Vergata University, Italy

Posters-Accepted Abstracts: J Nephrol Ther

Abstract :

Background: Diabetes is a strong risk factor for Peripheral Arterial Disease (PAD) and PAD has been reported at a rate of 50% in diabetic patients with foot lesion. End Stage Renal Disease (ESRD) under dialysis treatment is an independent risk factor for PAD and in diabetic patients increases the risk of ulceration, non healing ulcers and major amputation of lower limbs. Primary amputation rates of 22% to 44% have been reported for an ischaemic foot lesion in ESRD patients. Even if several studies suggest that angioplasty could be an attractive approach to treat Critical Limb Ischemia (CLI) in those patients, literature data are poor. The aim of this study was to assess the outcomes after Percutaneous Transluminal Angioplasty (PTA) in diabetic patients with PAD and ESRD. Methods: From a cohort of 456 diabetic patients who performed PTA because of CLI complicated by foot lesion, we have identified two groups according to dialysis treatment (D+) (n=60) or not (D-) (n=396). We report the outcomes at twelve months as: Limb salvage, major amputation, death. Results: ESRD+ were younger (67.4�?±1.3 vs. 70.7�?±0.5 p<0.02), had more ischemic heart disease (54 vs. 39.9% p<0.039) and more risk factors (4 risk factors 36 vs. 19% p<0.0036) than ESRD- patients. ESRD+ required re-PTA in a major number of occasions (30 vs. 16% p<0.0426) and had a technical failure after rePTA in a higher percentage (36.6 vs. 5.13% p<0.01). Outcomes for ESRD+ and ESRDpatients were respectively: Limb salvage (60 vs. 77.6%), major amputation (18.33 vs. 11.48%), death (21.67 vs. 10.97%) (Ï�?2=0.0175). Conclusions: Our data suggest that endovascular treatment could be a useful option to treat PAD in ESRD diabetic patients. In comparison to published data on similar patients treated by open by-pass we found a similar percentage of limb salvage but a reduced mortality (22 vs. 38%); further our results were obtained in all the population and not only on the survivors, in addition our patients were consecutive and therefore unselected ESRD patients. In conclusion, we consider that angioplasty of lower limbs is not only an attractive option but should be considered as a first line treatment for CLI in diabetic patients with ESRD.

Biography :

Email: luccioli@yahoo.com