Chronic kidney disease (CKD), defined by either microalbuminuria (MA) or a reduced
estimated glomerular filtration rate (eGFR), is associated with an increased risk
of peripheral arterial disease (PAD). The presence of both abnormalities might identify
a subgroup of adults at particularly high risk of PAD. Accordingly, we sought to evaluate
the combined effect of a reduced eGFR and MA on the prevalence of PAD among United
States adults. United States adults ≥40 years old (n = 6,951) participating in the
1999 to 2004 National Health and Nutrition Examination Survey were cross-classified
into 4 groups according to the presence or absence of MA (urinary albumin/creatinine
ratio ≥30 mg/g) and reduced eGFR (<60 mL/min/1.73 m2). PAD was defined as an ankle-brachial index of <0.9. The prevalence of PAD among
adults without MA or a reduced eGFR was 3.6% compared to 9.7%, 14.8%, and 25.4% among
adults with MA alone, reduced eGFR alone, and both reduced eGFR and MA, respectively.
After multivariate adjustment, the odds ratio for prevalent PAD associated with MA
alone, reduced eGFR alone, and both reduced eGFR and MA compared to those without
MA or reduced eGFR was 1.72 (95% confidence interval 1.16 to 2.55), 1.58 (95% confidence
interval 1.09 to 2.29), and 2.26 (95% confidence interval 1.30 to 3.94), respectively.
In conclusion, the coexistence of MA and reduced eGFR was associated with a high prevalence
of PAD and might be useful in identifying patients with vascular disease.
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Article Info
Publication History
Accepted:
June 28,
2009
Received in revised form:
June 28,
2009
Received:
May 3,
2009
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
