Published online Sep 15, 2017. doi: 10.4239/wjd.v8.i9.436
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
To determine if retinal and foot checks are carried out on patients with diabetes receiving haemodialysis.
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.
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.
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.
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.