The prevalence of peripheral artery disease in older adults with chronic kidney disease

Abstract

Aims:Not only severe but also mild to moderate chronic kidney disease (CKD) is an independent risk factor for peripheral artery disease (PAD). In this study, we examined the prevalence of PAD among older adults with mild-to-moderate CKD.Methods:The study was performed using the dataset of participants registered to a previous single-center, cross-sectional study that included non-institutionalized older adults aged 65 years or older in a geriatric outpatient setting. The subjects were patients with mild to moderate CKD. Ankle brachial index (ABI) was measured using a hand-held Doppler. PAD was diagnosed using an ABI value <0.9. The crude and adjusted prevalence of PAD were calculated.Results:A total of 554 patients were included (age: 75.4±6.2 years; female: 67.3%). PAD was detected by 8.2%, 27.1%, 60.0%, and 4.7%, in stage 1, 2, 3 and 4 CKD, respectively, with significant difference in stage 2 (p=0.003) and stage 3 (p=0.011) CKD compared with the stage 1 disease. PAD was also more prevalent in patients with reduced estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m2 vs. ≥60 mL/min/1.73 m2: 19.6% vs. 10.9%, p=0.005). However, after adjustment for potential confounders, the increase in the prevalence of PAD in subjects with lower eGFR was no longer significant (Odds ratio: 1.48, 95% confidence interval: 0.87-2.53, p=0.148).Conclusions:This study showed a higher prevalence of PAD among older adults with mild-to-moderate CKD; however, the difference appears to depend on existing confounders.

Keywords

• peripheral arterial disease
• chronic renal insufficiency
• glomerular filtration rate
• chronic kidney disease
• older adults