Correlation between Peripheral Arterial Disease and Stage of Chronic Kidney Disease
Phuangpaka Ungprasert MD*, Suwatchai Pornratanarangsi MD*
Affiliation : * Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Atherosclerotic disease is the most common disease in clinical practice. Risk factors for the disease include
diabetes, hypertension, dyslipidemia, smoking and chronic kidney disease (CKD). However, few studies have reported the
correlation between peripheral arterial disease (PAD) and stages of CKD. Ankle brachial index (ABI) is a non-invasive
method for detecting PAD with high sensitivity and specificity.
Objective : We studied the prevalence of asymptomatic PAD in patients with each stage of CKD using ABI measurement.
Material and Method: We conducted a study of patients with CKD classified by the Kidney Disease Outcomes Quality
Initiative classification (K/DOQI classification) who attended at outpatient clinics. The patients with symptomatic PAD will be
excluded. The participants will be sent to ABI measurement for the diagnosis of PAD, defined as ABI less than 0.9
Results : The total number of patients who had been enrolled in the study was 201; Male 55%. Mean age was 65.16 + 11.3
years. 22.4% of the patients have ABI less than 0.9 which was associated with older age, being female, and having lower
diastolic blood pressure (p = 0.002, < 0.001, < 0.0001, respectively) . Diabetes and coronary artery disease were higher in
patients with abnormal ABI but with no statistical significance. No difference in other risk factors, for example, hypertension,
dyslipidemia and smoking, was detected. Abnormal ABI was frequently seen in the patients with more advanced CKD and
mean ABI was lower in patients with more advanced CKD stage. The mean ABI of stage 4 and 5 CKD patients was lower than
that of stage 1 and 2 (p <0.05).
Conclusion : The prevalence of asymptomatic PAD increased with more advanced stage of CKD.
Keywords : Peripheral arterial disease, Chronic kidney disease, Ankle-brachial index
