Peripheral Arterial Disease in Patients With End-Stage Renal Disease

Authors:
  • SDSanto Dellegrottaglie
    Santo Dellegrottaglie
  • AFAnna L. Furniss
    Anna L. Furniss
  • BGBrenda W. Gillespie
    Brenda W. Gillespie
  • SSSudtida Satayathum
    Sudtida Satayathum
  • NLNorbert Lameire
    Norbert Lameire
  • ASAkira Saito
    Akira Saito
  • TATakashi Akiba
    Takashi Akiba
  • MJMichel Jadoul
    Michel Jadoul
  • NGNancy Ginsberg
    Nancy Ginsberg
  • MKMarcia Keen
    Marcia Keen
  • FPFriedrich K. Port
    Friedrich K. Port
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Abstract
Background— Patients with end-stage renal disease are at high risk for cardiovascular morbidity and mortality. The aims of the present study were to describe the prevalence of peripheral arterial disease (PAD) and its effects on prognosis and health-related quality of life (HRQOL) in an international cohort of patients on hemodialysis. Methods and Results— Data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective, international, observational study of hemodialysis patients (n=29 873), were analyzed. Associations between baseline clinical variables and PAD were evaluated by logistic regression analysis. Cox regression models were used to test the association between PAD and risk for all-cause mortality, cardiac mortality, and hospitalization. PAD was diagnosed in 7411 patients (25.3%) with significant geographic variation. Traditional cardiovascular risk factors including age, male sex, diabetes, hypertension, and smoking were identified, together with the duration of hemodialysis, as significant correlates of PAD. Diagnosis of PAD was associated with increased all-cause mortality (hazard ratio [HR]=1.36; P P P P P Conclusions— PAD is common in hemodialysis patients and is associated with increased risk of cardiovascular mortality, morbidity, and hospitalization and reduced HRQOL.

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