Preventing amputations in patients with end stage renal disease: whatever happened to foot care?

Lower extremity amputations in patients with diabetes are largely preventable through proper foot hygiene, routine foot surveillance, and patient education about proper foot care. Diabetics with end stage renal disease are at especially high risk for foot complications, but nephrology nursing has been largely silent about the importance of diabetic foot care. This article discusses the diabetic pathophysiology underlying the development of most foot complications and outlines the basic principles of safe and effective foot care.