Kidney Function Predicts the Risk of Asymptomatic Peripheral Arterial Disease in a Chinese Community-based Population

Purpose: Lower-extremity peripheral arterial disease (PAD) can predict the risk of subsequent cardiovascular disease (CVD) and all-cause mortality. Chronic kidney disease (CKD) as a precursor of CVD has been proven to be independently associated with PAD. However, few data exist regarding the prediction value of kidney function for incident asymptomatic PAD in community-based populations. We aimed to investigate the predicting value of estimated glomerular filtration rate (eGFR) for incident asymptomatic PAD in a Chinese community-based population. A total of 3549 subjects without PAD and eGFR > 30 ml/min/1.73 m were included.

Methods: PAD was defined by an ankle-brachial index (ABI) ≤ 0.9. Multivariate regression models were used to evaluate the associations.

Results: Subjects were 56.69 ± 8.56 years old and 35.9% were males. After 2.36 years of follow-up, the incidence of asymptomatic PAD was 3.1%. The risk of incident PAD was graded related to the categories of eGFR. Compared to participants with normal kidney function, the multivariate adjusted OR [95% CI] for new PAD was 1.31 (0.81-2.12) for those with mildly decreased kidney function, 4.13 (1.73-9.89) for those with grades 3 CKD (P for trend: 0.014). Baseline eGFR was significantly and linearly associated with incident PAD (OR [95% CI] for each 5 mL/min/1.73 m decrease of eGFR: 1.23 [1.09-1.38]) in participants with baseline eGFR < 90 mL/min/1.73 m but not in those with baseline eGFR ≥ 90 mL/min/1.73 m after adjustment for covariates.

Conclusion: Kidney function was an independent risk factor for development of incident PAD in community-based population with baseline eGFR ≤ 90 mL/min/1.73 m.