Chronic kidney disease (CKD) and peripheral arterial disease (PAD) share common risk factors. We assessed renal function and the prevalence of CKD in patients with PAD and investigated the characteristics of the risk factors for CKD in this population. Renal function of 421 patients with PAD was evaluated. Among the participants, 194 (46.1%) patients had decreased estimated glomerular filtration rate (eGFR). The prevalence of CKD was much higher among patients with PAD. Hypertension (odds ratios [ORs] 2.156, 95% confidence interval [CI] 1.413-3.289, P < .001), serum uric acid (OR 3.794, 95% CI 2.220-6.450, P < .001), and dyslipidemia (OR 1.755, 95% CI 1.123-2.745, P = .014) were significantly associated with CKD and the independent risk factors for CKD in patients with PAD. CKD is common and has a high prevalence in a population with PAD. Patients with PAD may be considered as a high-risk population for CKD. Recognition and modification of risk factors for CKD might beneficially decrease CKD incidence and improve prognosis in patients with PAD.
CollinsAJLiSGilbertsonDTLiuJChenSCHerzogCA. Chronic kidney disease and cardiovascular disease in the Medicare population. Kidney Int Suppl. 2003;87(11):S24–S31.
2.
GoASChertowGMFanDMcCullochCEHsuCY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med2004;351(13):1296–1305.
3.
JoostenMMPaiJKBertoiaML. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA. 2012;308(16):1660–1667.
4.
CriquiMHAboyansV. Epidemiology of peripheral artery disease. Circ Res. 2015;116(9):1509–1526.
5.
DeLoachSSMohlerER3rd. Peripheral arterial disease: a guide for nephrologists. Clin J Am Soc Nephrol2007;2(4):839–846.
6.
HamurHOnkOAVuruskanE. Determinants of chronic total occlusion in patients with peripheral arterial occlusive disease. Angiology. 201647. pii: 0003319716641827. [Epub ahead of print] PubMed PMID: 27059289.
7.
ZhanYDongYTangZZhangFHuDYuJ. Serum uric acid, gender, and low ankle brachial index in adults with high cardiovascular risk. Angiology. 2015;66(7):687–691.
8.
ZhangLWangFWangL. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet. 2012;379(9818):815–822.
9.
ChenJMohlerERXieD; CRIC Study Investigators. Traditional and non-traditional risk factors for incident peripheral arterial disease among patients with chronic kidney disease. Nephrol Dial Transplant. 2016;31(7):1145–1151.
10.
ChenJMohlerER3rdXieD; CRIC Investigators. Risk factors for peripheral arterial disease among patients with chronic kidney disease. Am J Cardiol. 2012;110(1):136–141.
11.
BrevettiGSchianoVChiarielloM. Endothelial dysfunction: a key to the pathophysiology and natural history of peripheral arterial disease?Atherosclerosis. 2008;197(1):1–11.
12.
O’HareAMGliddenDVFoxCSHsuCY. High prevalence of peripheral arterial disease in persons with renal insufficiency: results from the National Health and Nutrition Examination Survey 1999-2000. Circulation. 2004;109(3):320–323.
13.
UngprasertPPornratanarangsiS. Correlation between peripheral arterial disease and stage of chronic kidney disease. J Med Assoc Thai. 2011;94suppl 1:S46–S50.
14.
LiewYPBartholomewJRDemirjianSMichaelsJSchreiberMJJr. Combined effect of chronic kidney disease and peripheral arterial disease on all-cause mortality in a high-risk population. Clin J Am Soc Nephrol. 2008;3(4):1084–1089.
15.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):5–14.
16.
LaghariSUllahKMasroorIButtGKifayatF. Prevalence of peripheral arterial disease diagnosed by ankle brachial index among chronic kidney disease patients in a tertiary care unit. Saudi J Kidney Dis Transpl. 2015;26(5):924–930.
17.
LinCSChenSJSungCC. Hemodialysis is associated with increased peripheral artery occlusive disease risk among patients with end-stage renal disease: a Nationwide population-based cohort study. Medicine (Baltimore). 2015;94(28):e1164.
18.
O’RourkeMF. Link between macrocirculation and microcirculation in isolated systolic hypertension of older subjects. Am J Hypertens. 2009;22(5):469.
19.
TurnerSTRuleADSchwartzGL. Risk factor profile for chronic kidney disease is similar to risk factor profile for small artery disease. J Hypertens. 2011;29(9):1796–1801.
20.
GarimellaPSHartPDO’HareADeLoachSHerzogCAHirschAT. Peripheral artery disease and CKD: a focus on peripheral artery disease as a critical component of CKD care. Am J Kidney Dis. 2012;60(4):641–654.
21.
FlackJMNeatonJDDanielsBEsungeP. Ethnicity and renal disease: lessons from the multiple risk factor intervention trial and the treatment of mild hypertension study. Am J Kidney Dis. 1993;21(4 suppl 1):31–40.
22.
StevensLALiSWangC. Prevalence of CKD and comorbid illness in elderly patients in the United States: results from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2010;55(3 Suppl 2):S23–S33.
23.
LiangYYanZSunB. Cardiovascular risk factor profiles for peripheral artery disease and carotid atherosclerosis among Chinese older people: a population-based study. PLoS One. 2014;9(1): e85927.
MohlerER3rdHiattWRCreagerMA. Cholesterol reduction with atorvastatin improves walking distance in patients with peripheral arterial disease. Circulation. 2003;108(12):1481–1486.
26.
McDermottMMGuralnikJMGreenlandPPearceWHCriquiMHLiuK. Statin use and leg functioning in patients with and without lower-extremity peripheral arterial disease. Circulation. 2003;107(5):757–761.
27.
VaziriNDNavabMFogelmanAM. HDL metabolism and activity in chronic kidney disease. Nat Rev Nephrol. 2010;6(5):287–296.
28.
Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360(9326):7–22.
29.
TonelliMMoyéLSacksFMKiberdBCurhanG; Cholesterol and Recurrent Events (CARE) Trial Investigators. Pravastatin for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Ann Intern Med. 2003;138(2):98–104.
30.
AthyrosVGKatsikiNKaragiannisAMikhailidisDP. Statins can improve proteinuria and glomerular filtration rate loss in chronic kidney disease patients, further reducing cardiovascular risk. Fact or fiction?Expert Opin Pharmacother. 2015;16(10):1449–1461.
31.
LangloisMDe BacquerDDuprezD. Serum uric acid in hypertensive patients with and without peripheral arterial disease. Atherosclerosis. 2003;168(1):163–168.
32.
ShankarAKleinBENietoFJKleinR. Association between serum uric acid level and peripheral arterial disease. Atherosclerosis. 2008;196(2):749–755.
33.
Sánchez-LozadaLGTapiaESantamaríaJ. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int. 2005;67(1):237–247.
34.
KanellisJWatanabeSLiJH. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension. 2003;41(6):1287–1293.
