Having constant dialysis treatment usually requires dishing out huge amounts of cash. In fact, it’s so financially taxing that it may even literally cost you a leg someday.

According to a recent report, dialysis treatment have been independently linked to foot ulcerations, a skin ulcer that can lead to foot amputation if unchecked, in patients with diabetes and advanced stage IV or V chronic kidney disease.

The report recognized dialysis as an overlooked “risk factor” for the dreaded foot disease, stressing the need for patients to undergo intensive foot care to avoid amputation.

“Foot ulceration is a serious problem for people with diabetes which additionally results in huge economic costs,” wrote Agbor Ndip, MD, from Central Manchester University Hospitals NHS Foundation Trust in Manchester, United Kingdom, and colleagues.

A comparison between 326 diabetic patients in Manchester showed that those having dialysis had a higher prevalence of diabetic peripheral neuropathy or DPN (nerve damage in arms and legs), peripheral arterial disease or PAD (poor circulation in the legs), prior foot ulceration, foot amputation, and foot self-care, compared to those who did not have dialysis.

The data showed a significant gap in scores. Dialysis-treated patients had significantly higher occurrence of DPN (79% vs 65%), PAD (64% vs 43%), prior amputations (15% vs 6.4%), prior foot ulceration (32% vs 20%) and prevalent foot ulceration (21% vs 5%) than their non-dialysis treated counterparts. “Our findings have important clinical implications as they alert health care practitioners that dialysis is an independent risk factor for foot ulceration thus requiring extra vigilance and foot care,” said the study authors.

The study concluded that in terms of foot ulcer risk, dialysis should be ranked equivalent to having a history of previous foot ulceration, current foot ulcer, or prior amputation. Proper care and extreme caution should be taken by both the patient and doctor.

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