Haine, Axel; Haynes, Alan; Limacher, Andreas; Sebastian, Tim; Saengprakai, Wuttichai; Fuss, Torsten; Baumgartner, Iris (2018). Patency of the arterial pedal-plantar arch in patients with chronic kidney disease or diabetes mellitus. Therapeutic advances in cardiovascular disease, 12(5), pp. 145-153. Sage 10.1177/1753944718756605
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Haine TherAdvCardiovascDis 2018.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (382kB) |
BACKGROUND
Patency of the pedal-plantar arch limits risk of amputation in peripheral artery disease (PAD). We examined patients without chronic kidney disease (CKD)/diabetes mellits (DM) [PAD-control], those with DM without CKD, and those with CKD without DM.
METHOD
Uni- and multivariate logistic regression was used to assess association of CKD with loss of patency of the pedal-plantar arch and presence of tibial or peroneal vessel occlusion. Multivariate models adjusted for age, sex, hypertension, hyperlipidemia and smoking.
RESULTS
A total of 419 patients were included [age 75.2 ± 10.3 years, 288 (69%) male]. CKD nearly doubled the unadjusted odds ratio (OR) for loss of patency of the pedal-plantar arch. After adjustment, association remained significant for severe CKD [estimated glomerular filtration rate (eGFR) ≤ 29 ml/min compared with eGFR ≥ 60 ml/min, adjusted (adj.) OR 8.24 (95% confidence interval {CI} 0.99-68.36, p = 0.05)]. CKD was not related to risk of tibial or peroneal artery occlusion [PAD-control versus CKD, adj. OR 1.09 (95% CI 0.49-2.44, p = 0.83)] in contrast to DM [PAD-control versus DM, adj. OR 2.41 (95% CI 1.23-4.72, p = 0.01), CKD versus DM, adj. OR 2.21 (95% CI 0.93-5.22); p = 0.07)].
CONCLUSIONS
Below the knee (BTK) vascular pattern differs in patients with either DM or CKD alone. Severe CKD is a risk factor for loss of patency of the pedal-plantar arch.
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