Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease

Abstract

The prevalence and risk factors for renal artery stenosis (RAS) and chronic kidney disease (CKD) are unclear in Japanese patients with peripheral arterial disease (PAD). To examine these issues, we performed renal angiography in 410 patients with PAD. Renal function and damage were assessed using the estimated glomerular filtration rate (eGFR) and urinary level of microalbumin (MA). Multiple logistic and multiple regression analyses were used to examine the relationships of potential risk factors with RAS and CKD. In all, 94 subjects (22.9%) had RAS 450% and 45 subjects (11.0%) had RAS 475%. The incidences of an abnormal level of MA and renal insufficiency (eGFR o60 ml min -1 per 1.73 m 2 ) were 37.0 and 60.7%, respectively. RAS X50% was associated with critical limb ischemia (CLI; hazard ratio (HR) 2.519; 95% confidence interval (CI) 1.203-5.276, P¼0.014), coronary heart disease (CHD; HR 2.143; 95% CI 1.129-4.069; P¼0.020) and hypertension (HR 1.907; 95% CI 1.009-3.628; P¼0.045). RAS X75% had a relationship with hypertension (HR 3.093; 95% CI 1.002-9.548; P¼0.048). eGFR was negatively correlated with age, uric acid and CHD (P¼0.013), and MA had a significant positive correlation with low-density lipoprotein cholesterol, CLI, age, CHD and diabetes (Po0.001). These results show that the prevalences of RAS and CKD are very high in Japanese patients with PAD; that CLI and CHD are major risk factors for RAS; and that hyperuricemia, hypercholesterolemia and diabetes are risk factors for CKD in PAD. We also found that MA is a simple and noninvasive marker of renal dysfunction and general vascular damage.

Decreasing serum uric acid levels might be associated with improving estimated glomerular filtration rate (eGFR) in Japanese men

“…Yen CJ et al also showed that serum uric acid levels were associated with eGFR and decline in renal function in elderly Taiwanese subjects by longitudinal analysis [9]. In Japanese, hyperuricemia, hypercholesterolemia and diabetes are risk factors for CKD in peripheral arterial disease [19]. In the present study, there was weak relationship between eGFR and serum uric acid levels at baseline.…”

Prevalence of various comorbidities among veterans with chronic kidney disease and its comparison with other datasets

“…Indeed, we have shown previously that renovascular disease as defined by the presence of renal artery stenosis on angiogram or MRA, unequal kidney size or suggestive renal flow scans or renal failure with significant atherosclerotic vascular disease including CAD, PVD and CVA was the third common cause of CKD among elderly. 13 Kumukara et al 14 analyzed the prevalence of CKD among PVD. They performed renal angiography in 410 patients with PVD.…”

Decreasing serum uric acid levels are associated with improving estimated glomerular filtration rate (eGFR) in Japanese women

“…Compared with the lowest quartile of serum uric acid (referent), the multivariable odds ratio for quartiles 2-4, respectively, of CKD were 1.53, 2.16 and 4.67 in Appalachian adults [9]. In the Japanese population, hyperuricemia, hypercholesterolemia and diabetes were risk factors for CKD in peripheral arterial disease [18]. Iso et al reported that eGFR was negatively correlated with the change in serum uric acid [19].…”