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Novel and traditional cardiovascular risk factors for peripheral arterial disease in incident-dialysis patients.
Adv Chronic Kidney Dis. 2007 Jul; 14(3):304-13.AC

Abstract

Peripheral arterial disease (PAD), which threatens limb viability and patient survival, is increasing in frequency in the dialysis population, but associated risk factors remain poorly defined. We conducted a cross-sectional analysis of the association of novel and traditional cardiovascular risk factors with PAD in incident-dialysis patients enrolled in the CHOICE study by application of multivariate logistic-regression models with adjustment for confounders. Risk factors were determined by interview, record review, and laboratory analysis of frozen specimens. Among 922 patients, 25% had a diagnosis of PAD. After adjustment, higher prevalence of PAD was associated with increasing age (odds ratio [OR], 95% CI = 1.28 [range: 1.12 to 1.48] per 10-year increase in age); presence of diabetes mellitus (OR, 95% CI = 2.76 [range: 1.72 to 4.42]); higher Index of Co-Existent Disease (ICED), ICED 2 and ICED 3 versus ICED 0-1, (OR, 95% CI = 2.04; [range: 1.24 to 3.35] and OR, 95% CI = 2.81 [range: 1.83 to 4.30], respectively). After adjustment, we found no statistically significant association between CRP and prevalence of PAD. The prevalence of PAD diagnosis was 34% higher per quartile increase in Lp(a) (OR, 95% CI = 1.34 [range: 1.13 to 1.59]). Similarly, the prevalence of PAD diagnosis was 19% higher per quartile increase in total homocysteine (OR, 95% CI = 1.19 [range: 1.05 to 1.35]). The prevalence of PAD is high in incident-dialysis patients and is associated with several novel and traditional cardiovascular risk factors. This study identifies several novel risk factors (eg, Lp(a) and total homocysteine) and underscores the need for further research to reduce the burden of PAD in this high-risk group of patients.

Authors+Show Affiliations

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. bjaar@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17603986

Citation

Jaar, Bernard G., et al. "Novel and Traditional Cardiovascular Risk Factors for Peripheral Arterial Disease in Incident-dialysis Patients." Advances in Chronic Kidney Disease, vol. 14, no. 3, 2007, pp. 304-13.
Jaar BG, Plantinga LC, Astor BC, et al. Novel and traditional cardiovascular risk factors for peripheral arterial disease in incident-dialysis patients. Adv Chronic Kidney Dis. 2007;14(3):304-13.
Jaar, B. G., Plantinga, L. C., Astor, B. C., Fink, N. E., Longenecker, C., Tracy, R. P., Marcovina, S. M., Powe, N. R., & Coresh, J. (2007). Novel and traditional cardiovascular risk factors for peripheral arterial disease in incident-dialysis patients. Advances in Chronic Kidney Disease, 14(3), 304-13.
Jaar BG, et al. Novel and Traditional Cardiovascular Risk Factors for Peripheral Arterial Disease in Incident-dialysis Patients. Adv Chronic Kidney Dis. 2007;14(3):304-13. PubMed PMID: 17603986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novel and traditional cardiovascular risk factors for peripheral arterial disease in incident-dialysis patients. AU - Jaar,Bernard G, AU - Plantinga,Laura C, AU - Astor,Brad C, AU - Fink,Nancy E, AU - Longenecker,Craig, AU - Tracy,Russell P, AU - Marcovina,Santica M, AU - Powe,Neil R, AU - Coresh,Josef, PY - 2007/7/3/pubmed PY - 2007/8/24/medline PY - 2007/7/3/entrez SP - 304 EP - 13 JF - Advances in chronic kidney disease JO - Adv Chronic Kidney Dis VL - 14 IS - 3 N2 - Peripheral arterial disease (PAD), which threatens limb viability and patient survival, is increasing in frequency in the dialysis population, but associated risk factors remain poorly defined. We conducted a cross-sectional analysis of the association of novel and traditional cardiovascular risk factors with PAD in incident-dialysis patients enrolled in the CHOICE study by application of multivariate logistic-regression models with adjustment for confounders. Risk factors were determined by interview, record review, and laboratory analysis of frozen specimens. Among 922 patients, 25% had a diagnosis of PAD. After adjustment, higher prevalence of PAD was associated with increasing age (odds ratio [OR], 95% CI = 1.28 [range: 1.12 to 1.48] per 10-year increase in age); presence of diabetes mellitus (OR, 95% CI = 2.76 [range: 1.72 to 4.42]); higher Index of Co-Existent Disease (ICED), ICED 2 and ICED 3 versus ICED 0-1, (OR, 95% CI = 2.04; [range: 1.24 to 3.35] and OR, 95% CI = 2.81 [range: 1.83 to 4.30], respectively). After adjustment, we found no statistically significant association between CRP and prevalence of PAD. The prevalence of PAD diagnosis was 34% higher per quartile increase in Lp(a) (OR, 95% CI = 1.34 [range: 1.13 to 1.59]). Similarly, the prevalence of PAD diagnosis was 19% higher per quartile increase in total homocysteine (OR, 95% CI = 1.19 [range: 1.05 to 1.35]). The prevalence of PAD is high in incident-dialysis patients and is associated with several novel and traditional cardiovascular risk factors. This study identifies several novel risk factors (eg, Lp(a) and total homocysteine) and underscores the need for further research to reduce the burden of PAD in this high-risk group of patients. SN - 1548-5609 UR - https://www.unboundmedicine.com/medline/citation/17603986/Novel_and_traditional_cardiovascular_risk_factors_for_peripheral_arterial_disease_in_incident_dialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1548-5595(07)00059-6 DB - PRIME DP - Unbound Medicine ER -