5 RISK FACTORS OF PERIPHERAL ARTERY DISEASE IN THE HYPERTENSIVE CHRONIC KIDNEY DISEASE PATIENTS ON HEMODIALYSIS

Abstract

Background: Hypertensive chronic kidney disease (CKD) patients have increased risk of having peripheral artery disease (PAD), especially when combined with traditional PAD risk factors. Prevalence of PAD among CKD patients were variably reported. Objective: To analyze the risk factors of PAD in the hypertensive CKD patients on hemodialysis. Method: Cross-sectional study was conducted in December 2021 in Prof. dr. R. D. Kandou Hospital, Manado. Patients aged 18 years-old on hemodialysis at least twice a week for three months and taking anti- hypertension were included. Patients that refused and unable to be performed Ankle Brachial Index (ABI) due to physical limitation were excluded. Smoking, hemodialysis duration, anti-hypertension, alcohol intake history was taken. Laboratory (ureum-creatinine, albumin, lipid-profile, fasting-blood-glucose [FBG], hemoglobin, leukocyte, phosphate, calcium, uric acid, calcium-phosphate-product) and ABI examination was performed one day before patient's regular hemodialysis schedule. Result: On this study, among 30 patients, PAD prevalence was 50% with median age 55.5 (IQR 13) and 56.7% was male. Among those with PAD, 66.7% had PAD on both legs, 86.7% with mild PAD and 13.3% with moderate. All of them were asymptomatic. Diabetes mellitus (p=0,025), elevated FBG (p=0.006), and low-density-lipoprotein (LDL) level (p=0.017) were associated with PAD in this study. Other risk factors were not significant. Conclusion: PAD prevalence among hypertensive CKD patients on hemodialysis was high and all of them were asymptomatic. Diabetes mellitus, elevated FBG and LDL level were associated with PAD risk factors. Screening and management of PAD should be employed for those with risk factors.