Laghari Saeed, Ullah Kifayat, Masroor Imtiaz, Butt Ghias, Kifayat Farina
Department of Nephrology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
Saudi J Kidney Dis Transpl. 2015 Sep;26(5):924-30. doi: 10.4103/1319-2442.164572.
The objective of this study is to determine the prevalence of peripheral vascular disease (PVD) in patients with chronic kidney disease (CKD). Seventy-two patients with CKD stage 3 or above were included in this study. Blood samples were taken from each patient to determine complete blood counts, serum albumin, electrolytes, lipid profile and blood sugar random/fasting. The glomerular filtration rate (GFR) was estimated with the Cockcroft-Gault formula. The ankle-brachial index (ABI) was determined to identify the presence of PVD. A standardized Doppler ultrasound device was used. ABI of <0.90 was considered diagnostic of PVD. The mean age of the patients was 53.22 ± 12.8 years. Forty-six patients (63.9%) were male. Twenty-five patients (34.7%) were in stage 3 CKD, 20 patients (27.8%) were in stage 4 CKD and 27 patients (37.5%) were in stage 5 CKD. Twenty patients (27.8%) had an ABI <0.9 and hence had PVD. Of these patients, 13 (18.1%) had mild to moderate PVD with ABI of 0.41-0.90 and seven (9.7%) had severe PVD with ABI of 0.00-0.40. All the baseline parameters including systolic blood pressure (BP), diastolic BP, height, weight, body mass index, GFR, hemoglobin, total blood count, platelets, triglycerides, high-density lipoprotein, low-density lipoprotein and uric acid were not significantly different between patients with and without PVD (P >0.05). However, the mean total cholesterol was significantly higher among patients with PVD. The prevalence of PVD was significantly high in patients with stage 5 CKD (P <0.05). PVD is frequent among patients with CKD based on the ABI as measured by Doppler ultrasound.
本研究的目的是确定慢性肾脏病（CKD）患者外周血管疾病（PVD）的患病率。本研究纳入了72例3期及以上的CKD患者。采集每位患者的血样以测定全血细胞计数、血清白蛋白、电解质、血脂谱和随机/空腹血糖。采用Cockcroft-Gault公式估算肾小球滤过率（GFR）。通过测定踝臂指数（ABI）来确定是否存在PVD。使用标准化的多普勒超声设备。ABI<0.90被认为可诊断为PVD。患者的平均年龄为53.22±12.8岁。46例（63.9%）为男性。25例（34.7%）为3期CKD，20例（27.8%）为4期CKD，27例（37.5%）为5期CKD。20例（27.8%）患者的ABI<0.9，因此患有PVD。在这些患者中，13例（18.1%）患有轻度至中度PVD，ABI为0.41 - 0.90，7例（9.7%）患有重度PVD，ABI为0.00 - 0.40。所有基线参数，包括收缩压（BP）、舒张压、身高、体重、体重指数、GFR、血红蛋白、全血细胞计数、血小板、甘油三酯、高密度脂蛋白、低密度脂蛋白和尿酸，在有PVD和无PVD的患者之间均无显著差异（P>0.05）。然而，PVD患者的平均总胆固醇显著更高。5期CKD患者中PVD的患病率显著更高（P<0.05）。基于多普勒超声测量的ABI，PVD在CKD患者中很常见。
