2018 Volume 67 Issue 3 Pages 391-397
The sensation of cold feet was examined in contrast to skin temperature and skin perfusion pressure (SPP) in hemodialysis (HD) patients with and without diabetes. The subjects comprised 204 HD patients. Their ages ranged from 25 to 91 years. Dialysis history ranged from 1 month to 34 years and 1 month. We interviewed the subjects about their foot symptoms, measured the skin temperature of their feet using an infrared skin thermometer, and measured plantar SPP. The sensation of cold feet was experienced by 31 diabetic patients and 31 nondiabetic patients. While toe and plantar temperatures were significantly lower in diabetic patients with a sensation of cold feet, there were no significant differences in toe and plantar temperatures between nondiabetic patients with the sensation of cold feet and those without the sensation. A positive correlation was observed between skin temperature and plantar SPP in diabetic and nondiabetic patients. Plantar SPP was significantly lower in diabetic patients than in nondiabetic patients. In HD patients, a correlation was found between foot skin temperature and plantar SPP, and the low skin temperature of the feet in HD patients therefore appears to be attributed to impaired blood flow in the capillaries of the feet. Furthermore, diabetic HD patients with the sensation of cold feet also showed low foot temperature and low plantar SPP, which suggested the involvement of microangiopathy and vasomotor abnormality caused by autonomic disorder, which are complications of diabetes.
