Chronic Kidney Disease Is Associated With Increased PAD Risk
Chronic kidney disease (CKD) is associated with increased risk of peripheral artery disease (PAD), according to a recent meta-analysis.
Some existing data has indicated that that CKD is a risk factor for PAD, especially in the lower extremities.
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In their analysis, the researchers analyzed data from 817,084 patients enrolled in 21 international cohorts between 1972 and 2014. Data were obtained via the Chronic Kidney Disease Prognosis Consortium. All participants had a history of PAD, and some had CKD at baseline.
Various measures were used to analyze patients in accordance with baseline characteristics. For patients without baseline PAD, Cox proportional hazards models were used to determine associations of creatinine-based estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of PAD, including hospitalization with a diagnosis of PAD, intermittent claudication, leg revascularisation, and leg amputation. The researchers also evaluated discrimination improvement using c-statistics.
Results indicated that both measures used to assess CKD showed an association between CKD and incidence of PAD. The researchers also found that both eGFR and ACR significantly improved PAD risk discrimination beyond traditional predictors. Amputation predictions with ACR were especially improved.
“Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation,” the researchers concluded. “Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.”
—Christina Vogt
Reference:
Mutsushita K, Ballew SH, Coresh J, et al. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data [Published online July 14, 2017]. The Lancet Diabetes Endocrinol. doi:10.1016/S2213-8587(17)30183-3.