The Associations between Peripheral Artery Disease and Physical Outcome Measures in Men and Women with Chronic Kidney Disease

Abstract

Peripheral artery disease (PAD) is highly prevalent and associated with significant morbidity and mortality, but sex-based differences are incompletely understood. We sought to define the associations between PAD and physical outcome measures and to determine if these associations differed by sex in the Chronic Renal Insufficiency Cohort. Among 3,543 participants, we assessed the cross-sectional relationship between PAD severity defined by ankle-brachial index; and (1) physical activity (metabolic equivalent [MET]-hr/wk), (2) walking pace (slow versus medium and/or fast), and (3) physical function (12-item Short Form Health Survey [SF-12]) at baseline. In a multivariable linear regression model, PAD severity was not associated with physical activity defined by total MET-hr per wk in men or women (P=0.432). However, PAD severity was significantly associated with walking activity (P=0.037), although this relationship did not differ by sex (P=0.130). Similarly, PAD severity was significantly associated with walking pace (P<0.001), although this relationship did not differ by sex (P=0.086). In contrast, there was an independent association between PAD severity and SF-12 (P=0.018), with a significant interaction by sex (P<0.001). These data suggest that tools used to evaluate the functional consequences of PAD should focus on walking activity and walking pace, as well as physical function, where sex-specific associations should be accounted for.