[Peripheral vascular disease: prevalence, mortality and relationship with inflammation in hemodialysis].
Peripheral vascular disease (PVD) is a common disease among patients undergoing hemodialysis leading to increase morbidity and mortality with a high risk of inflammation and sepsis. The aim of the present study was to determinate PVD prevalence in our hemodialysis population and association with inflammation. The study sample consisted of 220 patients prevalents in hemodialysis. A basal study was made in 2001 and a follow up for 47 months. Data were collected retrospectively. PVD diagnosis was made attending to limb pulses and doppler in revisions. Diagnosis was classified as rest pain, ischemic ulceration and gangrene. Among a total of 220 patients, 89 had prevalent PVD. Thirty per cent had rest pain, 6,5% had ischemic ulceration and 3% had gangrene. Ninety five per cent underwent medical treatment, 0,5% were treated by percutaneous transluminal angioplasty (PTA), 2% were treated with surgical revascularization and 2,5% were treated with amputation. Patients with PVD were older, with higher Charlson index, diabetes, they hay higher CRP and fibrinogen serum levels; and lower albumin and prealbumine serum levels. Survival PVD was decreased in Kaplan-Meier (log rank =12,4; p<0,000). Adjusted Cox regression analysis revealed that PVD (p =0,034; OR =2,10; IC [1,06 ; 4,23]) ; age (p =0,001; OR =1,06; IC [1,03 ; 1,09]) and low serum albumin levels (p =0,012; OR =0,93; IC [0,89 ; 0,98]) predicted significantly the risk of mortality. PVD is an independent mortality risk factor in hemodialysis patients. An early diagnosis and treatment are able with examination and doppler. In our sample, a few patients are treated with PTA or surgical revascularization. There is an association between PVD and inflammation.
Vega
A
A
Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid. vega.almudena@gmail.com
Pérez García
R
R
Abad
S
S
Verde
E
E
López Gómez
J M
JM
Jofré
R
R
Puerta
M
M
Rodríguez
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies