Preventing amputations in patients with diabetes and chronic kidney disease.

Amputations of the lower extremities add significantly to the morbidity and mortality of patients with diabetes and chronic kidney disease (CKD). Dialysis nurses are in an optimal position to make a positive impact on the high rate of amputation among patients with diabetes receiving dialysis through early detection and intervention. Routine foot screening and education can assist in identifying and preventing ulcer-initiating events and reduce the incidence of lower extremity amputation in these patients. This article provides a review of the literature on evidence that assessment of the feet of patients with diabetes is successful in preventing amputations, as well as identifying risk factors for foot ulcers and amputation, assessment methods. The article will also describe a foot risk classification system that can predict the risk for amputations of the lower extremities.