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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Peripheral Artery Disease: Its Adverse Consequences With and Without CKD
Mathieu Bourrier1, Thomas W Ferguson2, John M Embil3
1Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Summary
Peripheral artery disease (PAD) is more prevalent in chronic kidney disease (CKD) patients, significantly increasing risks for mortality and lower-limb complications. Urgent interventions are needed to manage PAD in CKD populations.
Area of Science:
- Nephrology
- Vascular Surgery
- Epidemiology
Background:
- Chronic kidney disease (CKD) is a major risk factor for macrovascular disease and mortality.
- Peripheral artery disease (PAD) is more common in CKD patients, leading to increased lower-limb complications and death.
Purpose of the Study:
- To compare PAD prevalence in CKD versus non-CKD populations.
- To examine the impact of PAD on adverse health outcomes, including lower-limb complications, cardiovascular events, and survival.
Main Methods:
- Retrospective cohort study of 453,573 adult residents in Manitoba (2007-2014).
- PAD identified using hospital discharge codes and medical claims.
- Survival analysis conducted with Cox proportional hazards models.
Main Results:
- PAD prevalence was 4.5%, with higher rates in CKD patients (G3-G5 and G5D).
- PAD was associated with increased risks for mortality, cardiovascular events, and lower-limb complications across all CKD stages.
- CKD patients with PAD, especially those on dialysis (CKD G5D), faced substantially higher risks for lower-limb complications.
Conclusions:
- PAD is more common and leads to severe lower-limb complications in CKD patients.
- There is an urgent need for targeted medical interventions and care pathways to prevent lower-limb complications in CKD patients with PAD.
Keywords:
Epidemiologyarteriolosclerosiscardiovascular disease (CVD)chronic kidney disease (CKD)complicationsdialysisestimated glomerular filtration rate (eGFR)foot ulcerlower-limb amputationlower-limb complicationmortalitymortality/survivalnephrology and kidneyperipheral artery disease (PAD)renal functionserum creatinine (Scr)
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