The value of Doppler waveform analysis in predicting major lower extremity amputation among dialysis patients treated for diabetic foot ulcers

Abstract Aims This study examined the predictors for lower extremity amputation (LEA) in patients with diabetic foot ulcers according to kidney function and, in the case of dialysis patients, specifically evaluated the vasculature with the ankle–brachial index (ABI) and Doppler waveforms. Methods Among 658 diabetic patients admitted to the Diabetic Foot Care Center, 286 had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min per 1.73 m 2 , 275 had an eGFR  Results Forty-two percent of patients with eGFR   1.40, the proportion of dialysis patients (31.3%) was greater than the proportion of patients with eGFR  P  = 0.008) for major LEA among dialysis patients. The sensitivity and specificity were 88.0% and 59.6%, respectively. Conclusions Poor monophasic Doppler waveforms of below-the-knee arteries, commonly found among dialysis patients in treatment for diabetic foot ulcers, can serve as an independent predictor for major LEA.