Document Detail

Renal insufficiency is independently associated with a distal distribution pattern of symptomatic lower-limb atherosclerosis.
MedLine Citation:
PMID:  20060759     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to assess the impact of renal insufficiency (RI) on the distribution pattern of peripheral arterial disease (PAD). We hypothesised that RI is associated with a distally accentuated involvement of the peripheral arterial tree. DESIGN: This is a retrospective analysis. MATERIALS AND METHODS: Analysis was based on a consecutive series of 2709 patients with chronic PAD of atherosclerotic origin undergoing primary endovascular treatment of lower-extremity arteries. Atherosclerotic pattern was grouped into femoropopliteal (n=2085) and infragenicular (n=892) disease according to target lesions treated while using iliac disease (n=1133) as reference. Univariable and multivariable multinomial regression analyses were performed to assess relation with RI. Results are shown as relative risk ratio (RRRs) with 95% confidence intervals (95% CIs). A p<0.05 was considered statistically significant. RI was defined as glomerular filtration rate (GFR)<60 ml min(-1) 1.73 m(-2). RESULTS: Presence of RI was an independent risk factor for a centrifugal lesion pattern (RRR 1.48, 95% CI: 1.17-1.86, p=0.001). Moreover, a decrease in GFR by 10 ml min(-1) 1.73 m(-2) was associated with an RRR of 1.08 for below-the-knee arterial disease (95% CI: 1.03-1.13, p=0.003). CONCLUSION: Presence and severity of RI are independent predictors of a distal obstructive pattern in patients with symptomatic PAD.
S Wasmuth; I Baumgartner; D-D Do; T Willenberg; A Saguner; M Zwahlen; N Diehm
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Publication Detail:
Type:  Journal Article     Date:  2010-01-08
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  39     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  591-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
University Clinic of Angiology, Swiss Cardiovascular Center, Inselspital, University Hospital of Bern, Switzerland.
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MeSH Terms
Aged, 80 and over
Angiography, Digital Subtraction
Atherosclerosis / epidemiology,  etiology*,  radiography
Cardiovascular Diseases / epidemiology,  etiology
Glomerular Filtration Rate
Logistic Models
Lower Extremity / blood supply*
Middle Aged
Renal Insufficiency / complications*,  epidemiology,  physiopathology
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Switzerland / epidemiology

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