Serum Endocan Levels as a Risk Factor for Peripheral Artery Disease in Non-Dialysis Patients with Chronic Kidney Disease Stages 3-5

Background and Objectives: Peripheral arterial disease (PAD) is a severe manifestation of atherosclerosis that disproportionately affects patients with chronic kidney disease (CKD) stages 3-5, resulting in a higher prevalence in this group. Currently, it is challenging to detect early PAD in this patient population. This study investigated the association between serum endocan levels and PAD based on the ankle-brachial index (ABI) in non-dialysis patients with CKD stages 3-5. Materials and Methods: Specimens of blood and baseline demographic characteristics were gathered from a total of 164 patients presenting with stages 3-5 CKD, who were not receiving dialysis. We used a commercially available oscillometric technique to ascertain ABI values for our participants, and used a common and well-established threshold for defining low ABI, known to be associated with PAD: ABI values < 0.9. Endocan levels in patients' serum samples were measured by using enzyme-linked immunosorbent assays. Results: A total of 24 out of 164 people (14.6%) showed lower-than-normal ABIs. Compared to the group with normal ABIs, the individuals with low ABIs had more of the following conditions: diabetes mellitus (DM, p = 0.030), urine protein-to-creatinine ratio (p = 0.031), serum C-reactive protein concentrations (p = 0.037), and serum endocan levels (p < 0.001). After adjusting for variables significantly correlated with PAD by multivariate logistic regression analysis, age (odds ratio [OR]: 1.097, 95% confidence interval [CI]: 1.038-1.159, p = 0.001), DM (OR: 3.437, 95% CI: 1.053-11.225, p = 0.041), and serum endocan concentration (OR: 1.098, 95% CI: 1.042-1.157, p = 0.001) were identified as independent predictors of PAD in patients with CKD stages 3-5. Conclusions: Elevated serum endocan levels were found to be independent correlates of PAD in non-dialysis patients with CKD stages 3 through 5.