End-Stage Renal Disease Negatively Affects Physical Quality of Life in Patients With Diabetic Foot Complications

Raspovic, Katherine M.; Ahn, Junho; Fontaine, Javier La; Lavery, Larry A.; Wukich, Dane K.

doi:10.1177/1534734617707081

Cited by 21 publications

(19 citation statements)

References 41 publications

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“…adversely affects the physical quality of life in patients with diabetes, making them more susceptible to other critical health issues. [14][15][16] Studies carried out earlier in diabetic subjects revealed a potential relationship between DKDs and the development of DFU. 6,7 In an observational study conducted earlier to analyze the association of CKD and DFU, it was revealed that patients with CKD even in the initial stages showed a high threat for developing DFU leading to lower extremity amputation DFU.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Foot Ulcer as a Cause of Significant Decline in the Renal Function Among South Indian Population With Type 2 Diabetes: Role of TGF-β1 and CCN Family Proteins

Smina

Rabeka

Viswanathan

2019

The International Journal of Lower Extremity Wounds

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In the present study, a total of 428 South Indian subjects were divided into four different groups, consisting of individuals with type 2 diabetes without any other complications (T2DM), T2DM subjects with stage 2 and 3 diabetic kidney disease (CKD), T2DM subjects with grade 2 or 3 diabetic foot ulcer (DFU) and T2DM subjects having both diabetic kidney disease and diabetic foot ulcer (CKDDFU). The study was conducted ambispectively by comparing the changes in renal function among two consecutive periods, i.e., the period prior to the development of grade 2 and 3 diabetic foot ulcer (retrospectively) and after the development of DFU (prospectively). A gradual and uniform reduction of eGFR was observed throughout the study period in the subjects affected with either CKD or DFU alone. Whereas in subjects with both CKD and DFU, there was a sharp decline in the eGFR during the six months prior to the baseline, i.e., the period in which the development of ulcer and its progression to grade 2 or 3 happened. Remarkable elevations in the levels of TGF-β1 and CCN2 (CTGF), as well as a significant reduction in the level of CCN3 (NOV), were observed in the serum of CKDDFU group subjects, compared to the other groups. Increased production of TGF-β1 in response to the inflammatory stimulus from multiple sites in CKDDFU subjects caused a subsequent down-regulation of CCN3, followed by the activation of a large quantity of CCN2.

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Section: Discussionmentioning

confidence: 99%

Diabetic Foot Ulcer as a Cause of Significant Decline in the Renal Function Among South Indian Population With Type 2 Diabetes: Role of TGF-β1 and CCN Family Proteins

Smina

Rabeka

Viswanathan

2019

The International Journal of Lower Extremity Wounds

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“…Dialysis imposes a considerable burden on patients, with hospital visits two or three times per week, and each visit lasting 3–6 h. Dialysis patients have been reported as having low quality of life (QOL) (Yoshiya et al, 2001 ). Although patients' mental health QOL has been reported to be similar to that of the general population, QOL regarding physical aspects is remarkably low (Erez et al, 2016 ; Raspovic et al, 2017 ). Dialysis treatment is a long-term requirement, and family members and/or other caregivers are indispensable for successful continued treatment.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Dialysis Patients' Quality of Life and Caregivers' Quality of Life

et al. 2018

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Patients on dialysis require caregiving and assistance in their daily lives from family members and/or others for hospital visitation and supervised administration. This places a considerable burden on caregivers, which can in turn influence caregivers' quality of life (QOL). We recruited dialysis patients and their caregivers to elucidate how the QOL of patients relates to that of their caregivers'. Patients completed the EuroQol 5-Dimension scale (EQ-5D) and Kidney Disease Quality of Life-Short Form. Caregivers completed the EQ-5D and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). We calculated utility index values for the EQ-5D, and physical, mental (MCS), and role-social component summary scores for the SF-36. Compared to national norms, the caregivers of dialysis patients tended to have poor physical health-related QOL but normal mental health-related QOL, as also found with patients. The multivariate analysis revealed that ≥ median dialysis period and ≥ average burden of kidney disease were significantly related to caregiver MCS score (odds ratios; 6.79 and 9.89, respectively). Caregivers tended to have lower physical health-related QOL if their patients had high social QOL, and lower mental health-related QOL during the early stage of the patient's dialysis treatment, and when patients experienced low disease-targeted QOL.

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“…A recent study evaluated the impact of ESRD on HRQOL in patients with established DFD (36). The study group included 30 patients with ESRD on dialysis who had diabetes-related foot complications such as CN and DFU.…”

Section: The Impact Of Dfd On Hrqolmentioning

confidence: 99%

Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

Wukich

Raspovic

2018

Diabetes Care

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Patient-reported outcomes (PROs) have become an important subject in the area of diabetes-related foot complications. Self-reported health-related quality of life (HRQOL) surveys can provide a generic measure of overall health (global) and can be disease specific (i.e., diabetes) or even region specific (i.e., lower-extremity function). Analysis of PRO measures utilizing validated instruments allows health care providers to determine whether medical and surgical treatments are providing patients with the highest level of outcome possible and are actually improving HRQOL. The 36-item Short Form (SF-36), EuroQol five-dimension questionnaire (EQ-5D-5L), and Foot and Ankle Ability Measure (FAAM) are examples of commonly used HRQOL surveys. Low HRQOL has been associated with higher rates of hospital admission and mortality in patients with diabetes. Previous studies have demonstrated that patients with diabetes-related foot disease have low self-reported physical quality of life but do not typically report low mental quality of life. The impact of mental quality of life may be underestimated in these patients using the SF-36. In this article, we will discuss several widely used outcome instruments used to measure patient HRQOL and the impact of diabetic foot disease on HRQOL. As health care providers, we must continue to adjust and modify our treatments to achieve the best patient outcomes and associated high quality of life. Assessing PROs will become increasingly important as health care systems transition from a volume-based reimbursement model to a value-based model.

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End-Stage Renal Disease Negatively Affects Physical Quality of Life in Patients With Diabetic Foot Complications

Cited by 21 publications

References 41 publications

Diabetic Foot Ulcer as a Cause of Significant Decline in the Renal Function Among South Indian Population With Type 2 Diabetes: Role of TGF-β1 and CCN Family Proteins

Diabetic Foot Ulcer as a Cause of Significant Decline in the Renal Function Among South Indian Population With Type 2 Diabetes: Role of TGF-β1 and CCN Family Proteins

The Relationship Between Dialysis Patients' Quality of Life and Caregivers' Quality of Life

Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

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