Kidney function predicts the risk of asymptomatic peripheral arterial disease in a Chinese community-based population

Lower-extremity peripheral arterial disease (PAD) can predict the risk of subsequent cardiovascular disease (CVD) and all-cause mortality. Chronic kidney disease (CKD) as a precursor of CVD has been proven to be independently associated with PAD. However, few data exist regarding the prediction value of kidney function for incident asymptomatic PAD in community-based populations. We aimed to investigate the predicting value of estimated glomerular filtration rate (eGFR) for incident asymptomatic PAD in a Chinese community-based population. A total of 3549 subjects without PAD and eGFR > 30 ml/min/1.73 m² were included.

PAD was defined by an ankle-brachial index (ABI) ≤ 0.9. Multivariate regression models were used to evaluate the associations.

Subjects were 56.69 ± 8.56 years old and 35.9% were males. After 2.36 years of follow-up, the incidence of asymptomatic PAD was 3.1%. The risk of incident PAD was graded related to the categories of eGFR. Compared to participants with normal kidney function, the multivariate adjusted OR [95% CI] for new PAD was 1.31 (0.81-2.12) for those with mildly decreased kidney function, 4.13 (1.73-9.89) for those with grades 3 CKD (P for trend: 0.014). Baseline eGFR was significantly and linearly associated with incident PAD (OR [95% CI] for each 5 mL/min/1.73 m² decrease of eGFR: 1.23 [1.09-1.38]) in participants with baseline eGFR < 90 mL/min/1.73 m² but not in those with baseline eGFR ≥ 90 mL/min/1.73 m² after adjustment for covariates.

Kidney function was an independent risk factor for development of incident PAD in community-based population with baseline eGFR ≤ 90 mL/min/1.73 m².