Kidney function and risk of peripheral arterial disease: Results from the atherosclerosis risk in communities (ARIC) study

被引:187
作者
Wattanakit, Keattiyoat
Folsom, Aaron R.
Selvin, Elizabeth
Coresh, Josef
Hirsch, Alan T.
Weatherley, Beth D.
机构
[1] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN 55454 USA
[2] Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[4] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2007年 / 18卷 / 02期
关键词
D O I
10.1681/ASN.2005111204
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular disease, but its association with peripheral arterial disease (PAD) is unclear. With the use of data from the Atherosclerosis Risk in Communities (ARIC) Study, 14,280 middle-aged adults were categorized on the basis of estimated GFR >= 90, 60 to 89, and 15 to 59 ml/min per 1.73 m(2) for normal kidney function, mildly decreased kidney function, and stages 3 to 4 CKD, respectively. Incident PAD was defined as a new onset of ankle-brachial index < 0.9 assessed at regular examinations, new intermittent claudication assessed by annual surveillance, or PAD-related hospital discharges. Incidence rates and relative risks (RR) for PAD were compared across these categories. During a mean follow-up time of 13.1 yr (186,616 person-years), 1016 participants developed PAD. The incidence rates per 1000 person-years were 4.7, 4.9, and 8.6 for the normal kidney function, mildly decreased kidney function, and CKD groups, respectively. Compared with participants with normal kidney function, the age-, gender-, race-, and ARIC field center-adjusted RR for PAD was 1.04 (95% confidence interval [CI] 0.91 to 1.18) for those with mildly decreased kidney function and 1.82 (95% CI 1.34 to 2.47) for those with CKD. After additional adjustment for cardiovascular disease risk factors, an increase in risk for incident PAD still was observed in participants with CKD, with a multivariable adjusted RR of 1.56 (95% CI 1.13 to 2.14). Patients with CKD are at increased risk for incident PAD. Development of strategies for screening and prevention of PAD in this high-risk population seems warranted.
引用
收藏
页码:629 / 636
页数:8
相关论文
共 29 条
[1]  
[Anonymous], 1982, MINNESOTA CODE RESTI
[2]  
BAECKE JAH, 1982, AM J CLIN NUTR, V36, P936
[3]   Elevated fasting total plasma homocysteine levels and cardiovascular disease outcomes in maintenance dialysis patients - A prospective study [J].
Bostom, AG ;
Shemin, D ;
Verhoef, P ;
Nadeau, MR ;
Jacques, PF ;
Selhub, J ;
Dworkin, L ;
Rosenberg, IH .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1997, 17 (11) :2554-2558
[4]  
Chambless LE, 1997, AM J EPIDEMIOL, V146, P483, DOI 10.1093/oxfordjournals.aje.a009302
[5]   Calibration and random variation of the serum creatinine assay as critical elements of using equations to estimate glomerular filtration rate [J].
Coresh, J ;
Astor, BC ;
McQuillan, G ;
Kusek, J ;
Greene, T ;
Van Lente, F ;
Levey, AS .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2002, 39 (05) :920-929
[6]   Subclinical peripheral arterial disease in patients with chronic kidney disease:: Prevalence and related risk factors [J].
de Vinuesa, SG ;
Ortega, M ;
Martinez, P ;
Goicoechea, M ;
Campdera, FG ;
Luño, J .
KIDNEY INTERNATIONAL, 2005, 67 :S44-S47
[7]  
Dormandy J, 1999, Semin Vasc Surg, V12, P96
[8]   Prospective study of hemostatic factors and incidence of coronary heart disease - The Atherosclerosis Risk in Communities (ARIC) Study [J].
Folsom, AR ;
Wu, KK ;
Rosamond, WD ;
Sharrett, AR ;
Chambless, LE .
CIRCULATION, 1997, 96 (04) :1102-1108
[9]   Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals [J].
Fried, LF ;
Shlipak, MG ;
Crump, C ;
Bleyer, AJ ;
Gottdiener, JS ;
Kronmal, RA ;
Kuller, LH ;
Newman, AB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 41 (08) :1364-1372
[10]   Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization [J].
Go, AS ;
Chertow, GM ;
Fan, DJ ;
McCulloch, CE ;
Hsu, CY .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (13) :1296-1305