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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Novel and Traditional Cardiovascular Risk Factors for Peripheral Arterial Disease in Incident-Dialysis Patients
Advances in Chronic Kidney Disease, Volume 14, No. 3, Year 2007
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Description
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. © 2007 National Kidney Foundation, Inc.
Authors & Co-Authors
Jaar, Bernard
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
United States, Baltimore
Nephrology Center of Maryland
Plantinga, Laura C.
United States, Baltimore
Johns Hopkins School of Medicine
Astor, Brad C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Fink, Nancy E.
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Longenecker, Joseph Craig
Kuwait, Kuwait City
Kuwait University
Tracy, Russell P.
United States, Burlington
The University of Vermont
Marcovina, Santica Marija
United States, Seattle
University of Washington
Powe, Neil R.
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Coresh, Josef
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 27
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1053/j.ackd.2007.04.005
ISSN:
15485595
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Case-Control Study