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Updated: May 23, 2025

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

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Chronic Kidney Disease as an Independent Risk Factor for Chronic Lower Extremity Ulcers: A Cross-Sectional Analysis

Hai Gao1, Juanmin Yang1, Zhaohui Wang1

  • 1Department of Plastic and Cosmetic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

The International Journal of Lower Extremity Wounds
|May 22, 2025
PubMed

Insights

Chronic kidney disease (CKD) is linked to a higher risk of chronic lower extremity ulcers (CLEU) in US adults. This suggests CKD is an independent risk factor for these ulcers, emphasizing integrated care for CKD patients.

Area of Science:

  • Nephrology
  • Vascular Medicine
  • Public Health

Background:

  • Chronic lower extremity ulcers (CLEU) represent a significant health burden, often associated with diabetes and vascular diseases.
  • Chronic kidney disease (CKD) is increasingly recognized as a comorbidity linked to CLEU, but the relationship requires further elucidation.
  • Understanding the association between CKD and CLEU is crucial for managing patient populations with these overlapping conditions.

Purpose of the Study:

  • To investigate the association between chronic kidney disease (CKD) and the prevalence of chronic lower extremity ulcers (CLEU) in the adult population of the United States.
  • To determine if CKD is an independent risk factor for CLEU, controlling for various demographic and clinical confounders.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2004, including 8564 adult participants.
  • Defined CLEU based on self-reported leg or foot ulcers lasting over four weeks.
  • Diagnosed CKD using 2012 KDIGO guidelines (eGFR and UACR) and employed logistic regression for association analysis, adjusting for covariates.

Main Results:

  • Individuals with CKD exhibited a significantly higher likelihood of having CLEU (unadjusted OR: 2.33).
  • After adjusting for demographic factors, lifestyle, and comorbidities, CKD remained a significant independent risk factor for CLEU (adjusted ORs: 1.64 and 1.57).
  • Stratified analyses revealed no significant interaction effects across subgroups based on age, sex, diabetes, hypertension, hyperlipidemia, or peripheral artery disease (PAD).

Conclusions:

  • This study confirms a robust association between CKD and CLEU in US adults, identifying CKD as an independent risk factor.
  • Findings underscore the necessity for integrated management strategies for CKD patients to mitigate the risk of developing CLEU.
  • Further longitudinal research is warranted to establish causality and develop targeted interventions for this patient group.

Keywords:
NHANESchronic kidney diseasechronic lower extremity ulcerscross-Sectional analysislogistic regression

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