Renal Disease Increases Risk of PAD
CKD patients are at increased risk for peripheral arterial disease (PAD), researchers conclude.
Aaron R. Folsom, MD, of the University of Minnesota in Minneapolis, and his colleagues followed 14,280 middle-aged adults who participated in the Atherosclerosis Risk in Communities (ARIC) study. Subjects were grouped according to whether they had normal kidney function (estimated glomerular filtration rate 90 mL/min per 1.73 m2 or higher), mildly decreased kidney function (60-89 mL/min per 1.73 m2), or stages 3 to 4 CKD (15-59 mL/min per 1.73 m2).
PAD is defined as new-onset of ankle-brachial index less than 0.9, new intermittent claudication, or PAD-related hospital discharges.
During a mean follow-up time of 13.1 years (186,616 person-years), PAD developed in 1,016 participants, Dr. Folsom's group reported in the Journal of the American Society of Nephrology (2007;18:629-636). The PAD incidence rates per 1000 person-years were 4.7, 4.9, and 8.6 for the patients with normal kidney function, mildly decreased kidney function, and CKD, respectively.
Compared with subjects who had normal kidney function, subjects with CKD had a 56% increased risk of PAD after adjusting for CVD risk factors, age, gender, and other potential confounders.