Prevalencia de patología podológica y calidad de vida en pacientes trasplantados renales

Abstract

Objective: to determine the prevalence of podiatric pathology in kidney transplant patients with a functioning graft. To know the sociodemographic, anthropometric, medical variables and the comorbidity of the study group and its association with the probability of presenting podiatric pathology and measure quality of life. Methods: observational prevalence study (n=731). Kidney transplant patients (1981-2014) with a functioning graft will be included. The sociodemographic, anthropometric and medical characteristics of the patients will be defined; associated comorbidity (Charlson Score); the prevalence of podiatric pathology (digital and metatarsal formulas, forefoot-rearfoot relationship, rearfoot position, Fick's angle, loaded foot position (Foot Posture Index), biomechanical pathology, dermatologic pathology (skin and nail alterations), examination of the sensitivity (modified Neuropathy Disability Score + monofilament), plantar footprint study (pedigraph), footwear examination and pain intensity); quality of life (SF-36, ESRD-SCL, Foot Function Index and Foot Health Status Questionnaire questionnaires); and a questionnaire will be passed on attitudes, hygiene, figure of the podiatrist and footwear. Results: the most frequent pathologies are: skin pathology of exogenous origin (83.1%) and nail pathology of exogenous origin (85,4%). The most common biomechanical pathology is HAV (58.9%), followed by flat feet (45%) and claw toes (41.8%). It is determined that the variables associated with the dermatological pathology are sex, age, comorbidity, length of the left foot, width of the forefoot, type of footprint on the right foot, DM, and peripheral neuropathy. The variables associated with the presence of biomechanical pathology are: HAV (sex, age, forefoot width, type of footprint on the right foot, flat foot and claw toes), flat foot (comorbidity, BMI, forefoot width and HAV), claw toes (age, comorbidity, BMI, forefoot width and HAV). The quality of life and physical function taking into account the foot will worsen in the presence of flat feet, claw toes and dermatological pathology. The quality of life in kidney transplant recipients worsens in the presence of HAV and flat feet. There is a high agreement between observers for the diagnosis of the footprint. The highest agreement is presented by the Chippaux-Smirak index and the lowest agreement by the Staheli index. Conclusions: There is a high prevalence of dermatological pathology that modifies with age and the presence of peripheral neuropathy. The different biomechanical pathologies studied are modified with: HAV (age, sex, forefoot width and type of footprint of the right foot, flat foot and claw toes), flat foot (comorbidity, BMI, forefoot width and HAV) and claw toes (age, sex, comorbidity, BMI and HAV). The presence of dermatological pathology and biomechanical pathology significantly decrease people's quality of life and functionality, with the exception of HAV and skin and nail pathology in FFI. The presence of flat feet worsens the health-related quality of life in kidney transplant patients. The interobserver agreement for the diagnosis of podiatric pathology is high.