Although there is no general agreement on the definition of
renal foot, the ‘renal foot’ is a term often used to refer to
patients with stage 4/5 kidney disease. There are 5 divisions of renal failure. Patients
requiring dialysis are classed at level 4 or 5. Increased
awareness of this condition and careful clinical examination are critical to avoid serious complications. The potential consequence of poor management of the renal foot are
considerable: prolonged ulceration and ill health, gangrene and amputation,
depression and death.
The risk status of any patient on dialysis should automatically be considered as being high, in the absence of any active foot problems. A referral to a podiatrist for expert advice and treatment if an active foot problem is discovered.
The causal pathways of the foot in renal failure are multiple and inter-related. Three major pathologies--neuropathy, ischemia and infection--are the main contributory factors. Increased awareness of this condition and careful clinical examination avoid serious complications.
Patient Information and Inspection
All patients should be encouraged to carry out a daily inspection to look\ for:
Symptoms of the the ‘Renal Foot’ are:
Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary team approach. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Treatment of the renal foot can really only be done with the treatment of the patients' chronic kidney disease.