title: Skin perfusion pressure is a prognostic factor in hemodialysis patients.
abstract: Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Hatakeyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Saito
authors.forename: Kumiko
authors.initials: K
authors.lastname: Ishigaki
authors.forename: Hayato
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Akiko
authors.initials: A
authors.lastname: Okamoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Murasawa
authors.forename: Kengo
authors.initials: K
authors.lastname: Imanishi
authors.forename: Noriko
authors.initials: N
authors.lastname: Tokui
authors.forename: Teppei
authors.initials: T
authors.lastname: Okamoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Sugiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Kudo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoneyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Koie
authors.forename: Noritaka
authors.initials: N
authors.lastname: Kaminura
authors.forename: Hisao
authors.initials: H
authors.lastname: Saitoh
authors.forename: Tomihisa
authors.initials: T
authors.lastname: Funyu
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama