Prevalence and risk factors associated with peripheral artery disease in elderly patients undergoing peritoneal dialysis
Ding-Wei Kuang,1,2,* Chiu-Leong Li,1,* Un-I Kuok,1 Kin Cheung,1 Weng-In Lio,1 Jing Xin1,2
1Department of Nephrology, Centro Hospitalar Conde de São Januário, Macao, China; 2Department of Nephrology, Huashan Hospital, Shanghai, China
*These authors contributed equally to this work
Background: Rapid growth of the elderly peritoneal dialysis (PD) population is posing a special challenge for renal teams. Peripheral artery disease (PAD) has been reported to be an independent predictor of cardiovascular and all-cause mortality in hemodialysis patients. However, the prevalence and associated risk factors for PAD in elderly PD patients have not yet been fully investigated.
Methods: A total of 69 elderly PD patients were included in the present study. PAD was defined as either an ankle-brachial index < 0.9 or a history of intermittent claudication, lower-limb amputation, foot ulcers, or gangrene. On enrollment, clinical and biochemical characteristics were collected.
Results: The overall prevalence of PAD was 31.9%. Compared with non-PAD patients, PAD patients were significantly older and more likely to be female and have longer PD duration and lower diastolic blood pressure (P < 0.001, = 0.002, 0.018, and 0.007, respectively). Serum albumin level (P < 0.001) and residual renal Kt/V value (P < 0.001) were significantly lower, but the serum C-reactive protein level (P = 0.005) was significantly higher, in PAD patients compared with non-PAD patients. Logistic regression analysis showed that serum albumin level (odds ratio = 1.485, P = 0.040) and residual renal Kt/V value (odds ratio = 1.725, P = 0.016) were independently associated with PAD.
Conclusion: A high prevalence of PAD appeared among elderly PD patients in Macao. Serum albumin level and residual renal Kt/V value were independently related to PAD.
Keywords: ankle-brachial index, atherosclerosis, elderly, peripheral artery disease, peritoneal dialysis
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