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Kidney function predicts the risk of asymptomatic peripheral arterial disease in a Chinese community-based population

  • Nephrology - Original Paper
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Abstract

Purpose

Lower-extremity peripheral arterial disease (PAD) can predict the risk of subsequent cardiovascular disease (CVD) and all-cause mortality. Chronic kidney disease (CKD) as a precursor of CVD has been proven to be independently associated with PAD. However, few data exist regarding the prediction value of kidney function for incident asymptomatic PAD in community-based populations. We aimed to investigate the predicting value of estimated glomerular filtration rate (eGFR) for incident asymptomatic PAD in a Chinese community-based population. A total of 3549 subjects without PAD and eGFR > 30 ml/min/1.73 m2 were included.

Methods

PAD was defined by an ankle-brachial index (ABI) ≤ 0.9. Multivariate regression models were used to evaluate the associations.

Results

Subjects were 56.69 ± 8.56 years old and 35.9% were males. After 2.36 years of follow-up, the incidence of asymptomatic PAD was 3.1%. The risk of incident PAD was graded related to the categories of eGFR. Compared to participants with normal kidney function, the multivariate adjusted OR [95% CI] for new PAD was 1.31 (0.81–2.12) for those with mildly decreased kidney function, 4.13 (1.73–9.89) for those with grades 3 CKD (P for trend: 0.014). Baseline eGFR was significantly and linearly associated with incident PAD (OR [95% CI] for each 5 mL/min/1.73 m2 decrease of eGFR: 1.23 [1.09–1.38]) in participants with baseline eGFR < 90 mL/min/1.73 m2 but not in those with baseline eGFR ≥ 90 mL/min/1.73 m2 after adjustment for covariates.

Conclusion

Kidney function was an independent risk factor for development of incident PAD in community-based population with baseline eGFR ≤ 90 mL/min/1.73 m2.

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Acknowledgements

We thank all study team members for implementation and cooperation. We are also grateful for the organization by site managers Dr. Shuyu Wang and Dr. Liguang Dong. This study was supported by grants from Projects of National Natural Science Foundation of China (Grant 81703288), the University of Michigan—Peking University Health Science Centre (UM-PUHSC) Joint Institute for Translational and Clinical Research (Grant no: BMU20110177 and BMU20160530) and the Fundamental Research Funds for the Central Universities.

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Authors and Affiliations

  1. Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China

    Zhongli Wu, Xingang Wang, Jia Jia, Yuxi Li, Yimeng Jiang, Jianping Li, Yong Huo, Fangfang Fan & Yan Zhang

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  1. Zhongli Wu
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  2. Xingang Wang
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  8. Fangfang Fan
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  9. Yan Zhang
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Contributions

Prof YZ and FF had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YZ, FF, XW, YH. Conduct of study: YZ, FF, XW, YL, ZW, YJ, JJ. Data management and statistical analysis: FF, JJ. Drafting of the manuscript: ZW. Review and revision of the article: YZ, FF, XW, YL, YJ, JJ, YH. The final manuscript has been reviewed and approved by all authors.

Corresponding authors

Correspondence to Fangfang Fan or Yan Zhang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of both Peking University and Peking University First Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wu, Z., Wang, X., Jia, J. et al. Kidney function predicts the risk of asymptomatic peripheral arterial disease in a Chinese community-based population. Int Urol Nephrol 52, 525–532 (2020). https://doi.org/10.1007/s11255-020-02386-1

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