Harding JL, et al. - Despite recent data that rates of nontraumatic lower extremity amputation (NLEA) are declining among those with end-stage renal disease (ESRD) in the US, researchers intended to assess trends in diabetes and diabetes subgroups. Using data from the US Renal Data System, annual rates of NLEA hospitalizations were approximated among >2 million adults ≥18 years of age with ESRD from 2000–2015. Diabetes status, age, sex, race, and level of amputation (toe, foot, below the knee, and above the knee) were used to stratify age, sex, and race-adjusted NLEA rates. Data revealed that NLEA rates declined 43.8% from 2000 to 2013 and then stabilized among adults with diabetes; rates of total NLEAs declined 25.5% and then stabilized among adults without diabetes over the same time period. While a decline was seen initially, NLEA trends seem to have slowed down in this high-risk population with both ESRD and diabetes in recent years. A reduction in minor NLEAs (toe and foot) seen recently seems to be driving this, while major NLEAs (above the knee) continue to decline. Attention to preventive foot care in the ESRD population, especially for patients with diabetes, should be augmented.