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. 2019 Jul 26;20(1):281.
doi: 10.1186/s12882-019-1468-x.

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

Radislav R Ašćerić  1 , Nada B Dimković  2   3 , Goran Ž Trajković  4 , Biljana S Ristić  5 , Aleksandar N Janković  2 , Petar S Durić  2 , Nenad S Ilijevski  3   6
Affiliations

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

Radislav R Ašćerić et al. BMC Nephrol. .

Abstract

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.

Keywords: Ankle-brachial index; C-reactive protein; Hemodialysis; Hickman vascular access; Peripheral arterial disease.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of peripheral arterial disease in the hemodialysis patients according to age. X title: Age (years). Y title: Prevalence (%)
Fig. 2
Fig. 2
The median ankle-brachial index values in the hemodialysis patients with and without peripheral arterial disease. X title: PAD, w/o PAD. Y title: ABI value
See this image and copyright information in PMC

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