Prevalence and Clinical Correlates of Peripheral Arterial Disease in Hemodialysis Patients

血液透析患者的周邊動脈疾病盛行率及相關臨床表徵

林柏松(Paik-Seong Lim) ； 陳珍釵(Tsen-Tsai Chen) ； 楊士民(Shih-Ming Yang) ； 簡孝文(Shiaw-Wen Chien) ； 郭元銓(Yuan-Chuan Kuo) ； 白美安(Mei-An Tsai Pai)

《Acta Nephrologica》 19卷3期 (2005/10) Pp. 113-120

摘要

Background: Peripheral arterial disease (PAD) is the most common manifestation of systemic atherosclerosis and accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients. However, few studies have identified the prevalence and clinical correlates of PAD in this specific population.
Methods: Two hundred and thirty-four patients receiving stable HD ＞ 3 months from a single center were screened for PAD using the ankle-brachial index (ABI). The ABI was measured and a ratio of ＜ 0.9 was considered abnormal. Several biochemical and inflammatory parameters were also examined.
Results: The prevalence rate of PAD (ABI＜0.9) was 27.8%. ABI was positively correlated with serum albumin (r=0.134, p=0.41) and serum HDL-cholesterol (r=0.168, p=0.012) and negatively correlated with age (r=0.135, P=0.039), log-transformed CRP levels (r=-0.173, p=0.008), fasting blood sugar (r=0.263, p＜0.001) and serum triglyceride (r = 0.152, p = 0.20). In univariate analysis, PAD was found to be associated with hypertriglyceridemia, CRP levels, female gender, pre-existing CVD, and diabetes mellitus. Multivariate logistic regression analysis, however, revealed that PAD was associated with diabetes mellitus, pre-existing CVD, duration on dialysis and CRP levels.
Conclusion: In this preliminary study, we found that the prevalence of PAD in Taiwanese patients on HD is high. Presence of diabetes, pre-existing CVD, duration on dialysis and CRP levels independently predicts the presence of PAD.

並列摘要

Background: Peripheral arterial disease (PAD) is the most common manifestation of systemic atherosclerosis and accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients. However, few studies have identified the prevalence and clinical correlates of PAD in this specific population.
Methods: Two hundred and thirty-four patients receiving stable HD ＞ 3 months from a single center were screened for PAD using the ankle-brachial index (ABI). The ABI was measured and a ratio of ＜ 0.9 was considered abnormal. Several biochemical and inflammatory parameters were also examined.
Results: The prevalence rate of PAD (ABI＜0.9) was 27.8%. ABI was positively correlated with serum albumin (r=0.134, p=0.41) and serum HDL-cholesterol (r=0.168, p=0.012) and negatively correlated with age (r=0.135, P=0.039), log-transformed CRP levels (r=-0.173, p=0.008), fasting blood sugar (r=0.263, p＜0.001) and serum triglyceride (r = 0.152, p = 0.20). In univariate analysis, PAD was found to be associated with hypertriglyceridemia, CRP levels, female gender, pre-existing CVD, and diabetes mellitus. Multivariate logistic regression analysis, however, revealed that PAD was associated with diabetes mellitus, pre-existing CVD, duration on dialysis and CRP levels.
Conclusion: In this preliminary study, we found that the prevalence of PAD in Taiwanese patients on HD is high. Presence of diabetes, pre-existing CVD, duration on dialysis and CRP levels independently predicts the presence of PAD.

並列關鍵字

hemodialysis ； peripheral artery disease ； risk factors