Hypertensive patients with Chronic Kidney Disease are associated with cardiovascular disease. Peripheral Arterial Disease (PAD) is one of relatively underrated. The aim of this study is to identify the prevalence of PAD in hypertensive patients undergoing routine hemodialysis and its association with classic cardiovascular risk factors.
This is a multicenter cross sectional study that took place in 4 hemodialysis clinics in Jakarta from October to December 2016. We evaluated patients that have undergone hemodialysis for ≥6 months. PAD was diagnosed by Ankle Brachial Index (ABI). Patient was categorized as having PAD if ABI<0.9. Hypertension is defined as systolic BP ≥140mmHg or diastolic BP ≥90mmHg or taking antihypertensive medications. Analysis was done using Chi-square.
A total of 99 samples were collected, out of which 60 (60.6%) were male. The mean age of the patients were 52.7 (±12.6) years. There were 45 (45.5%) patients with PAD. PAD was significantly higher in patients aged >50 years (OR: 2.72, p: 0.025), male gender (OR: 2.75, p: 0.018), and in patients which had a history of smoking (OR:2.89, p:0.011). BMI, DM and alcohol history did not show any significant association with PAD.
Almost half of the population in this study have abnormal ABI, which categorized them to have PAD. Age >50 years, male gender and positive smoking history are the factors that are associated with risk for PAD. DM as one of major risk factor of cardiovascular disease do not associate with PAD in this population, which assume that in hypertensive hemodialysis patients DM would not add any significant contribution in the presence of PAD.