Peripheral arterial disease and kidney failure: a frequent association

Objectives: To determine the prevalence of kidney failure in people older than 49 years old with peripheral arterial disease and to analyse its relationship with risk factors and cardiovascular disease. Material and method: Prospective epidemiological study 3 years in duration with selection by simple random sampling in the general population aged over 49 years. Data on demographic, clinical, prevalence of risk factors and cardiovascular disease were registered. We defined peripheral arterial disease (PAD) by ankle-brachial index (ABI) <= 0.9 and chronic kidney disease (CKD) according to estimated glomerular filtration rates by the MDRD <60 ml/min/1.73m(2). Baseline data are presented. Results: 511 people were included. The mean age was 66.6 (9.7) years (SD), 37% were men. The prevalence of PAD was 12.4% (N=63) of the sample, average age 72.6 years, 46% men. The presence of CKD stages 3-5 was 39.7%. Patients with PAD and CKD compared with those with normal renal function were older (75.6 vs. 70.6, p=0.08), predominantly women (64% vs 47.4%, p=ns), and showed higher values for systolic and diastolic blood pressure (159.2 vs 146.1, p=ns and 85.7 vs 80.3 mmHg, p=0.09), CRP (1.23 vs 0.38 mg/dl, p=0.05) and albumin creatinine ratio (90.2 vs 26.4 mg/g, p=ns). In this group, the prevalence of cardiovascular risk factors and associated cardiovascular disease, were significantly higher without reaching statistical significance. Conclusions: Kidney failure is present in 39.7% of patients with PAD and it defines a subgroup of patients with high cardiovascular risk.