Clinical Characteristics of Patients on Hemodialysis With Peripheral Arterial Disease

Matsuzawa, Ryota; Aoyama, Naoyoshi; Yoshida, Atsushi

doi:10.1177/0003319715572678

Cited by 23 publications

(33 citation statements)

References 46 publications

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“…The early diagnosis and management of PAD can improve the prognosis for patients on HD [11]. Therefore, many patients on HD with PAD could avoid or at least delay adverse events, such as amputations, cardiovascular events, and death if PAD was timely diagnosed and adequately treated [12]. The traditional risk factors for PAD, namely, age, diabetes mellitus (DM), smoking, hyperlipidemia, hypertension, and male sex, are well recognized within the general population [7], but these risk factors are supplemented by other risk factors in patients on HD [13, 14].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, clinical characteristics, and predictors of peripheral arterial disease in hemodialysis patients: a cross-sectional study

et al. 2019

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Background Peripheral arterial disease (PAD) is common in patients with end-stage renal disease on hemodialysis, but is frequently underdiagnosed. The risk factors for PAD are well known within the general population, but they differ somewhat in hemodialysis patients. This study aimed to determine the prevalence of PAD and its risk factors in patients on hemodialysis. Methods This cross-sectional study included 156 hemodialysis patients. Comorbidities and laboratory parameters were analyzed. Following clinical examinations, the ankle-brachial index was measured in all patients. PAD was diagnosed based on the clinical findings, ankle-brachial index < 0.9, and PAD symptoms. Results PAD was present in 55 of 156 (35.3%; 95% CI, 27.7–42.8%) patients. The patients with PAD were significantly older (67 ± 10 years vs. 62 ± 11 years, p = 0.014), more likely to have diabetes mellitus ( p = 0.022), and anemia ( p = 0.042), and had significantly lower serum albumin ( p = 0.005), total cholesterol ( p = 0.024), and iron ( p = 0.004) levels, higher glucose ( p = 0.002) and C-reactive protein ( p < 0.001) levels, and lower dialysis adequacies ( p = 0.040) than the patients without PAD. Multivariate analysis showed higher C-reactive protein level (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.00–1.06; p = 0.030), vascular access by Hickman catheter (OR, 4.66; 95% CI, 1.03–21.0; p = 0.045), and symptoms of PAD (OR, 5.20; 95% CI, 2.60–10.4; p < 0.001) as independent factors associated with PAD in hemodialysis patients. Conclusion The prevalence of PAD was high among patients with end-stage renal disease on hemodialysis. Symptoms of PAD, higher C-reactive protein levels, and Hickman vascular access were independent predictors of PAD in patients on hemodialysis.

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Section: Introductionmentioning

confidence: 99%

Prevalence, clinical characteristics, and predictors of peripheral arterial disease in hemodialysis patients: a cross-sectional study

et al. 2019

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“…Peripheral arterial disease (PAD) is an atherosclerotic process that manifests in the lower extremities, which is a common complication of end-stage renal disease (ESRD) (1,2) and results in a reduced quality of life (3), in addition to an increased risk of mortality (4)(5)(6). While PAD is likely an important marker of the cardiovascular status, it has not been researched as thoroughly as coronary artery disease and its pathogenesis in patients undergoing dialysis is not well understood (7).…”

Section: Introductionmentioning

confidence: 99%

Increased prevalence of peripheral arterial disease in patients with obese sarcopenia undergoing hemodialysis

Tian

Zhang

2018

Exp Ther Med

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Background peripheral arterial disease (PAD) is a common complication in patients undergoing dialysis, which reduces the quality of life and increases the risk of mortality. Recent literature has documented an association between increased visceral fat (VF) content and a proatherogenic factors in end-stage renal disease. The present study investigated the prevalence of PAD in patients undergoing hemodialysis. PAD was determined as an ankle-brachial index <0.9. Additionally, VF content was determined using multiple frequency bioelectrical impendence analysis. The nutritional status of the patients was evaluated by subjective global assessment and endothelial function was measured by ultrasonographic brachial artery flow-mediated dilatation. Patients divided into two groups (malnourished and non-malnourished) with two further subgroups in each (high VF and low VF content). The prevalence of PAD was identified to be significantly higher in patients with a high VF mass compared with a low VF mass in non-malnourished patients. PAD was significantly more common in malnourished patients compared with non-malnourished patients (P<0.01). The presence of PAD in patients undergoing hemodialysis was identified to be significantly correlated with age, diabetes mellitus (DM) status VF content, malnutrition, serum albumin level, diastolic blood pressure and log C-reactive protein levels. Furthermore, logistic regression analysis determined that age, DM, VF content and malnutrition were significant independent risk factors for PAD in patients undergoing hemodialysis. In conclusion, the results of the present study indicated that obesity and malnutrition act synergistically to increase the risk of PAD in patients undergoing dialysis.

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“…PAD is an important manifestation of systemic atherosclerosis and is observed commonly in HD patients. The prevalence of PAD is markedly high in HD patients, although approximately 68.7% are asymptomatic [10]. One reason for the high proportion of asymptomatic PAD among HD patients is that habitual physical activity levels are reportedly low in these patients [11], and given that HD patients often have peripheral neuropathy due to a high prevalence of diabetes [12], their leg symptoms such as pain and numbness are masked.…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic peripheral artery disease and mortality in patients on hemodialysis

et al. 2018

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Clinical Characteristics of Patients on Hemodialysis With Peripheral Arterial Disease

Cited by 23 publications

References 46 publications

Prevalence, clinical characteristics, and predictors of peripheral arterial disease in hemodialysis patients: a cross-sectional study

Prevalence, clinical characteristics, and predictors of peripheral arterial disease in hemodialysis patients: a cross-sectional study

Increased prevalence of peripheral arterial disease in patients with obese sarcopenia undergoing hemodialysis

Asymptomatic peripheral artery disease and mortality in patients on hemodialysis

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