Abstract 314: Determinants of Endothelial Dysfunction in Peripheral Artery Disease: Importance of Kidney Disease
OBJECTIVES: Peripheral artery disease (PAD) and chronic kidney disease are both associated with endothelial dysfunction. Renal insufficiency may contribute to the progression of endothelial dysfunction in PAD patients, increasing their morbidity and mortality. We hypothesized that worsening renal function (RF) is associated with impaired endothelial function (EF) in patients with PAD.
METHODS: This was a cross-sectional study of PAD patients presenting to a vascular surgery clinic. Brachial artery flow-mediated vasodilation (FMD) was done to assess EF. RF was determined by calculating estimated glomerular filtration rate (eGFR). Linear regression was performed to assess the relationship between EF and RF in claudicants.
RESULTS: 115 claudicants with eGFR ≥ 30ml/min participated in this study. Mean age was 69 ± 8 years, 97% were male, and 77% were Caucasian. Comorbidities included hypertension (90%), dyslipidemia (83%), coronary artery disease (41%) and diabetes mellitus (36%). Mean ABI was 0.71 ± 0.15 and mean FMD was 7.0% ± 3.8, indicating impaired EF. As RF declined (p=0.001), EF decreased. After multivariable regression adjusting for age, race, log TNF-α, hypertension, dyslipidemia, and diabetes, only eGFR remained associated with FMD (p=0.030).
CONCLUSIONS: In patients with PAD, worsening renal function has a stronger association with endothelial dysfunction than traditional cardiovascular risk factors do. Further longitudinal studies are needed to explore whether stabilization of renal function may decrease the risk of PAD progression associated with endothelial dysfunction, as well as the risk of major adverse cardiovascular events and mortality.
Author Disclosures: K.C. Chong: None. C.D. Owens: None. M. Park: None. H.F. Alley: None. M.S. Conte: None. W.J. Gasper: None. M. Grenon: None.
- © 2014 by American Heart Association, Inc.