There is a high prevalence of PAD (17.7%) in patients with stage 3-5 CKD, and calcium channel blocker use in hypertensive patients is associated with a lower risk of PAD.
High PAD prevalence in CKD warrants screening vigilance; CCB association is observational and leaves open any protective effect.
Patients with chronic kidney disease (CKD) are at increased risk for atherosclerosis and peripheral artery disease (PAD). We studied the possible related risk factors and hypertension treatment in CKD patients with PAD. One hundred and twenty-four patients with stages 3 to 5 of CKD, as described by the Kidney Outcome Quality Initiatives (K/DOQI) classification, were included in this study. Neither the patients on dialysis nor with PAD were included. The ankle-brachial index (ABI) was calculated using the Fukuda Vascular Screening system VaSera VS-1000(superscript TM). Patients were diagnosed with PAD if the ABI for one of the legs was <0.9. Patient characteristics and their laboratory data were collected. There were 22 (17.7 %) participants with PAD. Higher systolic blood pressure, higher diastolic blood pressure, and increased pulse pressure showed a strong association with PAD. On further analysis, significantly fewer patients were treated with calcium channel blocker in hypertensive CKD patients with PAD (χ^2 =7.055, p=0.008). The multiple logistic regression analysis in hypertensive patients demonstrated the risk factors for PAD was pulse pressure, and calcium channel blocker treatment negatively correlate with ABI<0.9 in CKD patients (odds ratio=0.232, 95% CI=0.07-0.73, p=0.013). There was a high prevalent rate of PAD in CKD patients, especially those with hypertension. ABIs may be routinely used for early diagnosis and therapeutic management.
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Yang et al. (2010) studied this question.
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