title: Peripheral arterial disease predicts overall and cardiovascular mortality in peritoneal dialysis patients.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis and is common among dialysis patients. Cardiovascular disease (CVD) accounts for the leading cause of mortality in dialysis patients, and PAD has been found as a predictor for cardiovascular as well as overall mortality in general population. However, the study on the role of PAD in the prognosis of peritoneal dialysis patients is rather limited.
  
  
  METHODS
  Prevalent continuous ambulatory peritoneal dialysis patients over 60 years old were recruited in this study and were followed-up regularly to death or the end of the study. The diagnosis of PAD was based on ankle-brachial pressure index (ABI) < 0.9 or intermittent claudication. Univariate and multivariate Cox proportional hazard models were used to identify the risk factors for cardiovascular and overall mortality. Survival curves were estimated by the Kaplan-Meier method followed by log-rank test to compare the mortality rate between PAD and non-PAD patients.
  
  
  RESULTS
  One hundred and seventy-one patients were included and 62 (36%) had PAD complication. In the follow-up of 24.4 (median 34.6) months, 36 deaths were recorded: 19 from PAD group and 17 from non-PAD group. Twenty-one patients died due to CVD: 13 from PAD group and 8 from non-PAD group. The presence of PAD and serum albumin was found independently associated with cardiovascular and overall mortality using Cox proportional hazards model.
  
  
  CONCLUSIONS
  PAD is very common in aged peritoneal dialysis patients and independently associated with both cardiovascular and overall mortality.
authors.affiliation: Division of Nephrology, Peking University Third Hospital, Beijing, China.
authors.forename: Shun-Li
authors.initials: SL
authors.lastname: Tian
authors.forename: Xin-Kui
authors.initials: XK
authors.lastname: Tian
authors.forename: Qing-Feng
authors.initials: QF
authors.lastname: Han
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
mesh_terms: D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000150:complications; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications*; D010530:Peritoneal Dialysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis