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Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Background

The incidence of lower extremity amputation is increasing in patients with chronic kidney disease (CKD), but symptoms of peripheral arterial disease (PAD) in patients with CKD are uncommon. The aim of the current study was to assess the value of the vascular calcification (VC) score on plain radiographs of the feet for the prediction of PAD in patients with CKD.

Methods

We recruited 102 patients with CKD (24 pre-dialysis, 58 hemodialysis [HD], and 20 peritoneal dialysis [PD]). We defined the VC score on the plain radiographs of the feet as follows: score 0, no calcification; score 1, the length of the VC is <5 cm in a single foot or <2 cm in both feet; and score 2, the length of the VC is >5 cm in a single foot or >2 cm in both feet. We evaluated the atherosclerotic calcified plaques of the femoral or popliteal artery with Doppler ultrasonography and compared it with the VC score.

Results

Patients with high VC scores showed more atherosclerotic calcified plaques in the femoral or popliteal artery (P < 0.01). The prevalence of PAD in patients with CKD was closely related with the VC score (P < 0.01). PAD was associated with diabetes, a higher hsCRP, and a lower total cholesterol level (P < 0.01). The VC score was a significant predictor of the presence of PAD (odds ratio: 6.66, P < 0.001).

Conclusions

Asymptomatic CKD patients, including those on HD and PD, may have PAD and routine testing by plain radiographs of the feet followed by Doppler ultrasonography are of pivotal significance, especially if the patients are diabetic.

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Acknowledgments

This study was supported by research funds from Dong-A University.

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Authors and Affiliations

  1. Department of Internal Medicine, Dong-A University, 3 Ga-1, Dongdaesin-Dong, Seo-Gu, Busan, 601-715, Korea

    Won Suk An, Young Ki Son, Seong-Eun Kim & Ki-Hyun Kim

  2. Department of Radiology, Dong-A University, Busan, Korea

    Seong Kuk Yoon

  3. Department of Physiology, Dong-A University, Busan, Korea

    Hae-Rahn Bae

  4. Department of Pathology, Dong-A University, Busan, Korea

    Seo-Hee Rha

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  1. Won Suk An
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  2. Young Ki Son
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  3. Seong-Eun Kim
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  4. Ki-Hyun Kim
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  5. Seong Kuk Yoon
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Correspondence to Won Suk An.

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An, W.S., Son, Y.K., Kim, SE. et al. Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease. Int Urol Nephrol 42, 773–780 (2010). https://doi.org/10.1007/s11255-009-9697-8

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  • DOI: https://doi.org/10.1007/s11255-009-9697-8

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