Division of Nephrology, Department of Internal Medicine (S-WW, T-WH, H-RC), Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; and Division of Nephrology (S-WW, C-KL, T-WH, H-CT, H-RC, J-DL), Chung Shan Medical University Hospital, Taichung, Taiwan.
Am J Med Sci. 2014 Apr;347(4):267-70. doi: 10.1097/MAJ.0b013e3182896a33.
Peripheral arterial disease (PAD) is a common finding in patients at various stages of chronic kidney disease; however, there has only been a limited amount of data that have been published regarding the prevalence and associated risk factors of subclinical PAD in renal transplant recipients.
The authors cross sectionally investigated the prevalence of PAD using ankle-brachial index (ABI) in 304 renal transplant recipients with no previous diagnosis of PAD. Patients were considered to have subclinical PAD when ABI <0.9. The authors also determined the associated risk factors for subclinical PAD.
The mean age of the 304 patients was 53 years, and 30 patients (9.9%) had a history of atherosclerotic event (including past cardiovascular and cerebrovascular events). Twenty-five of the 304 patients (8%) had ABI <0.9 and 1 had (0.3%) ABI >1.3. Compared to patients with normal ABI, a history of atherosclerotic events is the only independent risk factor for patients with subclinical PAD (P = 0.0468).
Subclinical PAD is an inadvertent issue in renal transplant patients, especially those with a history of atherosclerotic events. Further research is needed on the long-term clinical impact and optimal treatment of subclinical PAD among renal transplant patients.
外周动脉疾病(PAD)是慢性肾脏病各阶段患者的常见表现;然而,仅有少量数据报道了肾移植受者亚临床 PAD 的患病率和相关危险因素。
作者通过踝肱指数(ABI)对 304 例无 PAD 既往诊断的肾移植受者进行横断面研究,以调查 PAD 的患病率。ABI<0.9 时,患者被认为患有亚临床 PAD。作者还确定了亚临床 PAD 的相关危险因素。
304 例患者的平均年龄为 53 岁,30 例(9.9%)有动脉粥样硬化事件史(包括过去的心血管和脑血管事件)。25 例(8%)ABI<0.9,1 例(0.3%)ABI>1.3。与 ABI 正常的患者相比,动脉粥样硬化事件史是亚临床 PAD 患者的唯一独立危险因素(P=0.0468)。
亚临床 PAD 是肾移植患者的一个意外问题,尤其是有动脉粥样硬化事件史的患者。需要进一步研究亚临床 PAD 在肾移植患者中的长期临床影响和最佳治疗方法。