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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.2K

Outcomes Among Patients With End-stage Kidney Disease and Chronic Limb-threatening Ischemia: A Population-based

Samir K Shah1, Dan Neal2, Terrie Vasilopoulos3

  • 1Division of Vascular Surgery, Department of Surgery, University of Florida, Gainesville, FL.

Annals of Surgery
|October 29, 2024
PubMed

Insights

Patients with end-stage kidney disease (ESKD) and chronic limb-threatening ischemia (CLTI) face poor outcomes. Open surgery showed superior two-year survival compared to amputation, with other treatments having similar survival rates.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Patient Outcomes

Background:

  • End-stage kidney disease (ESKD) and chronic limb-threatening ischemia (CLTI) frequently coexist.
  • Limited research exists on outcomes for patients with both conditions.

Purpose of the Study:

  • To analyze mortality and secondary outcomes in patients with ESKD and CLTI.
  • Compare outcomes across different treatment modalities: no procedure, amputation, endovascular, and open surgery.

Main Methods:

  • Retrospective national cohort study using United States Renal Data System (USRDS) data (2016-2019).
  • Identified 3,908 patients with ESKD and incident CLTI.
  • Propensity matching used for exploratory analysis of two-year survival by treatment.

Main Results:

  • One-year mortality was 44.9%; 90-day major postoperative complications were 41.8%; 90-day readmissions were 52.6%.
  • No significant difference in two-year survival between amputation and endovascular treatment (P=0.08).
  • Open surgery demonstrated superior two-year survival compared to amputation (P=0.002).

Conclusions:

  • Patients with both ESKD and CLTI have poor prognoses regardless of treatment.
  • Open surgery appears to offer better long-term survival than primary amputation in this population.
Abstract

Keywords:
United States Renal Data Systemchronic limb-threatening ischemiaend-stage kidney diseaseperipheral arterial disease

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