Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2017; 8(9): 436-439
Published online Sep 15, 2017. doi: 10.4239/wjd.v8.i9.436
Eye and foot checks in patients with diabetes on haemodialysis: Are they done, and who does them?
Nadira Bibi Mothojakan, Shazia Hussain, Kieran McCafferty, Mohammed Magdi Yaqoob, Tahseen Ahmad Chowdhury
Nadira Bibi Mothojakan, Shazia Hussain, Tahseen Ahmad Chowdhury, Department of Diabetes and Metabolism, Barts Health NHS Trust, the Royal London Hospital, Whitechapel, London E1 1BB, United Kingdom
Kieran McCafferty, Mohammed Magdi Yaqoob, Department of Nephrology, Barts Health NHS Trust, the Royal London Hospital, Whitechapel, London E1 1BB, United Kingdom
Author contributions: Mothojakan NB and Hussain S undertook the research and data analysis; Mothojakan NB wrote the first draft of the manuscript; McCafferty K and Yaqoob MM instigated the research and reviewed the manuscript; Chowdhury TA reviewed the manuscript and undertook all revisions and is the guarantor.
Institutional review board statement: The study was reviewed and approved by the Barts Health Department of Renal Medicine Clinical Governance Board.
Informed consent statement: All patients involved in the survey gave full verbal consent.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: All authors agree to data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tahseen Ahmad Chowdhury, Professor, Consultant in Diabetes, Department of Diabetes and Metabolism, Barts Health NHS Trust, the Royal London Hospital, 7th Floor, John Harrison House, Whitechapel, London E1 1BB, United Kingdom. tahseen.chowdhury@bartshealth.nhs.uk
Telephone: +44-20-82238384 Fax: +44-20-82238806
Received: January 22, 2017
Peer-review started: January 23, 2017
First decision: April 14, 2017
Revised: May 9, 2017
Accepted: May 30, 2017
Article in press: May 31, 2017
Published online: September 15, 2017
Abstract
AIM

To determine if retinal and foot checks are carried out on patients with diabetes receiving haemodialysis.

METHODS

Eighty-four patients with diabetes receiving haemodialysis were asked if they recalled having eye and foot screening in the last year, and if so, by whom was the check done.

RESULTS

Seventy-seven (91.7%) patients recalled having an eye check in the preceding 12 mo. Of these, 52 (67.5%) did so in an ophthalmology clinic, 17 (22%) in retinal screening, three (3.9%) in an optician clinic. Three patients (3.9%) went to both ophthalmology and retinal screening, and two (2.6%) attended an ophthalmology and optician. Seventy (83.3%) patients recalled having a foot check in the preceding 12 mo. Of these, 33 (47.1%) were done by practice nurse, 14 (20%) by a diabetes nurse, 11 (15.7%) by a general practitioner, eight (11.4%) by a chiropodist, and four (5.7%) were each checked by renal nurse, diabetes consultant, junior doctor, or unknown person at a foot clinic.

CONCLUSION

Most patients with diabetes on haemodialysis are able to recall having an eye check in the last year, although 8.3% could not. A significant proportion of patients could not recall having a foot check (16.7%) in the last year. This baseline audit suggests that an improvement in the rate of foot screening is important to achieve in patients with diabetes on haemodialysis in our unit.

Keywords: Diabetes, Haemodialysis, Foot screening, Retinal screening

Core tip: Diabetes is the commonest cause of end stage renal failure in many countries. Patients with diabetes on haemodialysis are at high risk of retinal and foot problems, and need regular screening to ensure they do not develop problems related to these complications. Our survey suggests that most patients are getting eye checks, but a significant number are not getting foot checks. This is an important area for all dialysis units to consider. We recommend that patients have foot screening whilst on dialysis, which may require further training for dialysis nurses.