Lower-Extremity Peripheral Arterial Occlusive Disease Among Patients With End Stage Renal Disease: Epidemiological Investigation

Objective: To investigate ultrasonic characteristics of peripheral arterial diseases and the prevalence rate and risk factors of PAOD among ESRD patients with color Doppler ultrasonography. Compared with the result of color Doppler ultrasonography, the sensitivity of ankle-brachial index(ABI) to diagnose PAOD among ESRD is measured to determine whether ABI is a sensitive way of screening asymptomatic PAOD patients from ESRD patients.Methods: Color Doppler ultrasound examinations are performed on all patients at double carotid arteries, brachial arteries, femoral arteries, posterior tibial arteries and dorsalis pedis artery to determine PAOD diagnostic information including their tunica intima, lumen diameters, plaques, peaks of systolic velocity, end diastolic velocities, mean velocities, pulse indices and resistant indices. In addition, Ankle-branchial index (ABI) was calculated on basis of the systolic pressures at systolic pressures at double brachial arteries(non-fistula side for patients with fistulas), posterior tibial arteries and dorsalis pedis arteries, which were determined with a 5 MHz Dopper prober.Results: The prevalence of lower-extremity PAOD in ESRD patients was significantly higher than that in control group (50.68% vs 14.29%, PO.001); If An ABI0.90 or less was defined as PAOD, the sensitivity and specificity of ABI for lower-extremity PAOD in ESRD patients were 81.08% and 97.22% respectively, and Kappa value was 0.78±0.12; age, inflammatory status, parathyroid dysfunction, disorder of phosphorus metabolism and malnutrition were likely to be main risk factors of PAOD.Conclusion: Lower-extremity PAOD was highly common in ESRD patients and its prevalence arrived at 50.68%, most of which were extensively distributed at multiple sites and segments of peripheral arteries. Malnutrition, inflammatory status, disorders of phosphorus metabolism and parathyroid dysfunction were main risk factors of this condition. Lower-extremity PAOD was often asymptomatic and ABI was a reliable screening tool for this disorder in ESRD population.