Departamento de Cardiopneumologia, Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal.
Arq Bras Cardiol. 2013 Apr;100(4):362-7. Epub 2013 Apr 2.
Patients with peripheral arterial disease (PAD) have a high risk of developing cardiovascular events. There is a high prevalence of PAD in individuals with kidney disease and both are important risk factors for cardiovascular events.
The aim of this study was to investigate the association between PAD and renal function in hypertensive patients.
The sample consisted of 909 individuals with arterial hypertension. The presence of PAD was evaluated using the ankle-brachial index (ABI) method and renal function was assessed based on the estimated glomerular filtration rate (eGFR). The subjects were divided into groups, according to abnormal (ABI < 0.9) and normal ABI (ABI 0.9-1.4).
The percentage of subjects with abnormal ABI was 8%. In the group of individuals with abnormal ABI, prevalence of CKD was 23.4%, compared to a prevalence of 11.2% in patients with normal ABI. Multivariable logistic regression analysis, after adjusting the model to the conventional cardiovascular risk factors, identified a statistically significant and independent effect of eGFR on the likelihood of developing PAD, with an OR of 0.987 (CI: 0.97-1.00).
An independent association between PAD and chronic kidney disease was observed in the present study. Therefore, the combination of an accurate diagnosis of kidney disease and routine ABI evaluation could constitute a more efficient means to identify subclinical PAD, allowing individuals to benefit from early interventions, aiming at reducing cardiovascular risk.
患有外周动脉疾病（PAD）的患者发生心血管事件的风险很高。患有肾脏疾病的个体中 PAD 的患病率很高，两者都是心血管事件的重要危险因素。
本研究旨在探讨高血压患者中 PAD 与肾功能之间的关系。
该样本由 909 名患有动脉高血压的个体组成。使用踝臂指数（ABI）方法评估 PAD 的存在，根据估计肾小球滤过率（eGFR）评估肾功能。根据 ABI 异常（ABI<0.9）和正常 ABI（ABI 0.9-1.4）将受试者分为两组。
ABI 异常的受试者百分比为 8%。在 ABI 异常的组中，CKD 的患病率为 23.4%，而 ABI 正常的患者患病率为 11.2%。多变量逻辑回归分析，在调整了常规心血管危险因素模型后，发现 eGFR 对发生 PAD 的可能性具有统计学意义和独立影响，OR 为 0.987（CI：0.97-1.00）。
本研究观察到 PAD 与慢性肾脏病之间存在独立关联。因此，准确诊断肾脏疾病并常规进行 ABI 评估相结合，可能是识别亚临床 PAD 的更有效手段，使个体受益于早期干预，从而降低心血管风险。
