Abstract

Aim: to analyze the occurrence of foot complications after the introduction of a standardized foot examination within an extensive cohort of prevalent diabetic Hemodialysis patients across three Hemodialysis centers in the Marathwada region of Maharashtra state. Methods: A standardized foot examination was performed in 200 prevalent diabetic Hemodialysis patients in Aurangabad (n=94), Jalna (n =56), and Beed (n=50) in the Marathwada region of Maharashtra state for two years (October 2021 – September 2023). Foot complications were categorized using the Wagner classification system, which spans grades 0 to 5. Peripheral artery disease (PAD) was assessed based on clinical pulse measurements, with classifications assigned as normal (grade 0), weak (grade 1), or absent (grade 2). Results: Based on the Gavin weighted score, in individuals with diabetic nephropathy undergoing haemodialysis, the diabetic foot risk factors were distributed as follows: 20.63% in the low-risk group, 69.84% in the medium-risk group, and 9.52% in the high-risk group. Within the diabetic nephropathy with haemodialysis cohort, cases classified as Grade 0 according to the Wagner classification amounted to 57, constituting 90.47%. The remaining cases comprised 6 cases of diabetic foot (9.52%), along with 4 cases classified as Grade 1 (6.35%), 1 case as Grade 2 (1.59%), and 1 case as Grade 4 (1.59%), respectively. Conclusion: The implementation of a standardized foot examination protocol among diabetic patients undergoing hemodialysis revealed a noteworthy prevalence of clinically significant complications that demand careful consideration.

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