Renal insufficiency is independently associated with a distal distribution pattern of symptomatic lower-limb atherosclerosis

Wasmuth, S; Baumgartner, I; Do, D-D; Willenberg, T; Saguner, A; Zwahlen, M; Diehm, N (2010). Renal insufficiency is independently associated with a distal distribution pattern of symptomatic lower-limb atherosclerosis. European journal of vascular and endovascular surgery EJVES, 39(5), pp. 591-596. London: Elsevier 10.1016/j.ejvs.2009.11.034

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Objectives

The purpose of this study was to assess the impact of renal insufficiency (RI) on the distribution pattern of peripheral arterial disease (PAD). We hypothesised that RI is associated with a distally accentuated involvement of the peripheral arterial tree.

Design

This is a retrospective analysis.

Materials and Methods

Analysis was based on a consecutive series of 2709 patients with chronic PAD of atherosclerotic origin undergoing primary endovascular treatment of lower-extremity arteries. Atherosclerotic pattern was grouped into femoropopliteal (n = 2085) and infragenicular (n = 892) disease according to target lesions treated while using iliac disease (n = 1133) as reference. Univariable and multivariable multinomial regression analyses were performed to assess relation with RI. Results are shown as relative risk ratio (RRRs) with 95% confidence intervals (95% CIs). A p < 0.05 was considered statistically significant. RI was defined as glomerular filtration rate (GFR) < 60 ml min−1 1.73 m−2.

Results

Presence of RI was an independent risk factor for a centrifugal lesion pattern (RRR 1.48, 95% CI: 1.17–1.86, p = 0.001). Moreover, a decrease in GFR by 10 ml min−1 1.73 m−2 was associated with an RRR of 1.08 for below-the-knee arterial disease (95% CI: 1.03–1.13, p = 0.003).

Conclusion

Presence and severity of RI are independent predictors of a distal obstructive pattern in patients with symptomatic PAD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Baumgartner, Iris, Willenberg, Torsten Andreas, Zwahlen, Marcel, Diehm, Nicolas Alexander

ISSN:

1078-5884

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:07

Last Modified:

05 Dec 2022 14:00

Publisher DOI:

10.1016/j.ejvs.2009.11.034

PubMed ID:

20060759

Web of Science ID:

000278631600013

BORIS DOI:

10.7892/boris.213

URI:

https://boris.unibe.ch/id/eprint/213 (FactScience: 196931)

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