CKD biomarkers could identify risk of future peripheral artery disease

Written by Sankeetha Nadarajah, Future Science Group

Findings, published in The Lancet, Diabetes & Endocrinology, record the results from a large collaborative meta-analysis of international prospective cohorts. The results demonstrate that a lower estimated glomerular filtration rate and higher urinary albumin-to-creatinine ratio appeared to increase the risk of developing future vascular disease, amongst patients without symptomatic peripheral artery disease at baseline.

The team led by Kunihiro Matsushita, (Johns Hopkins Bloomberg School of Public Health; MD, USA), analyzed adult participants without peripheral artery disease at baseline at the individual patient level. Cox proportional hazards models were utilized to quantify relations of creatinine-based estimated glomerular filtration rate, urine albumin-to-creatinine ratio and dipstick proteinuria with the incidence of peripheral artery disease. This included hospitalization with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularization and leg amputation. Discrimination improvement through c-statistics was also assessed.

Data from 817,084 adults without a history of peripheral artery disease at baseline, from 21 cohorts, was analyzed and when followed up, 18,261 cases of peripheral artery disease were recorded. The researchers demonstrated that estimated glomerular filtration rate and urinary albumin-to-creatinine ratio were independently associated with the incidence of peripheral artery disease.

These findings led to the interpretation that clinical attention should be given to the development of peripheral artery disease symptoms in patients with any stage of chronic kidney disease.

Matsushita K, Ballew S.H, Coresh J et al. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. doi:10.1016/S2213-8587(17)30183-3 (Epub ahead of print);