Presence of peripheral arterial disease predicts loss of residual renal function in incident CAPD patients
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Updated: Jun 2, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Shun-li Tian1, Xin-kui Tian, Qing-feng Han
1Tianjin Geriatric Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
Insights
Peripheral arterial disease (PAD) is linked to faster loss of residual renal function (RRF) in dialysis patients. Early detection of PAD may help preserve kidney function and improve patient survival.
Area of Science:
- Nephrology
- Cardiology
- Vascular Medicine
Background:
- End-stage renal disease (ESRD) patients commonly experience accelerated cardiovascular disease (CVD), including peripheral arterial disease (PAD).
- Residual renal function (RRF) is a critical predictor of survival in ESRD patients, potentially linked to CVD severity.
- The specific association between PAD and the decline of RRF has not been previously quantified.
Purpose of the Study:
- To investigate the relationship between peripheral arterial disease (PAD) and the decline in residual renal function (RRF) among patients undergoing continuous ambulatory peritoneal dialysis.
- To identify predictors of RRF loss in this patient population.
Main Methods:
- A cohort of incident continuous ambulatory peritoneal dialysis patients was studied.
- Peripheral arterial disease (PAD) was diagnosed using an ankle-brachial index < 0.9.
- Residual renal function (RRF) was assessed as the mean of 24-hour urea and creatinine clearances; Cox proportional hazards models identified RRF loss predictors.
Main Results:
- The study included 86 patients; 23 had baseline PAD. Over a median follow-up of 18 months, baseline PAD, peritonitis, inflammation, serum uric acid, Ca×P, and serum phosphate were associated with >50% RRF decrease.
- Multivariate analysis revealed baseline PAD, Ca×P, and peritonitis as independent predictors of RRF decline.
Conclusions:
- Peripheral arterial disease (PAD) may serve as a significant clinical marker for cardiovascular disease, predicting the loss of residual renal function (RRF) in dialysis patients.
- Further research is needed to determine if PAD interventions can improve renal vascular health and slow RRF decline.
Background:
Accelerated cardiovascular disease (CVD), including peripheral arterial disease (PAD), is very common in patients with end-stage renal disease. Residual renal function (RRF) is a strong predictor of patient survival that is suggested to be linked to the degree of CVD. However, the relationship between PAD and decline in RRF has not previously been measured.
Methods:
We studied incident continuous ambulatory peritoneal dialysis patients from Peking University Third Hospital. An ankle brachial index of less than 0.9 was used to diagnose PAD. Residual renal function (RRF) was determined as the mean of 24-hour urea and creatinine clearances (glomerular filtration rate). The Cox proportional hazards model was used to identify factors predicting loss of RRF.
Results:
The study included 86 patients (age: 61 ± 14 years; men: 51%), 23 of whom had PAD at baseline. Mean follow-up was 19 months (median: 18 months; range: 6 - 30 months). In univariate analysis, baseline PAD, peritonitis during follow-up, inflammation (C-reactive protein), serum uric acid, Ca×P, and serum phosphate were all significantly associated with a greater-than-50% decrease in RRF during follow-up. In multivariate analysis, only baseline PAD, Ca×P, and peritonitis were independently associated with a decline in RRF.
Conclusions:
Our study suggests that PAD may be a clinically important marker of CVD predicting the loss of RRF. It remains to be determined whether interventions aimed at decreasing PAD may also improve renal vascular status and thus slow the rate of RRF decline.
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