Hui-Ju Tsai1,2, Jiun-Chi Huang1,3,4,5, Yi-Chun Tsai1,3,5, Ling-I Chen3, Szu-Chia Chen1,3,4,5, Jer-Ming Chang5,6, Hung-Chun Chen3,7. 1. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 5. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Department of Internal Medicine, Kaohsiung Municipal Cijin Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 7. Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
AIM: Peripheral artery occlusive disease (PAOD) is associated with increased rates of cardiovascular mortality, morbidity and hospitalization in patients undergoing dialysis. An ankle-brachial index (ABI) less than 0.9 has been used to diagnose PAOD. The aim of this study was to evaluate associations among inflammation, malnutrition and their interactions on the risk of PAOD. METHODS: Two hundred and twenty-two haemodialysis patients (mean age 61.0 ± 11.7 years, 56.8% men) were enrolled and stratified into four groups according to median values of albumin (3.87 g/dL) and logarithm of C-reactive protein (CRP) (0.48 mg/L). Associations between the study groups and an ABI less than 0.9 were assessed using multiple logistic regression analysis. Receiver operating characteristic curves were constructed to predict an ABI less than 0.9. RESULTS: A lower level of albumin and higher level of CRP were significantly associated with an ABI less than 0.9 in multivariate analysis (odds ratio, 5.688; 95% confidence interval, 1.369-23.626; P = 0.017) after adjusting for demographic, clinical, biochemical and medication data. The interaction between albumin and CRP in relation to an ABI less than 0.9 was significant in multivariate analysis (odds ratio, 1.797; 95% confidence interval, 1.258-2.568; P = 0.001). The areas under the curve for albumin, CRP and albumin + CRP for the prediction of ABI less than 0.9 were 0.311, 0.654 and 0.733, respectively. CONCLUSION: Patients undergoing haemodialysis with a lower albumin level and higher CRP level have an increased risk of PAOD. A combination of malnutrition and inflammation may be associated with PAOD in haemodialysis patients.
AIM: Peripheral artery occlusive disease (PAOD) is associated with increased rates of cardiovascular mortality, morbidity and hospitalization in patients undergoing dialysis. An ankle-brachial index (ABI) less than 0.9 has been used to diagnose PAOD. The aim of this study was to evaluate associations among inflammation, malnutrition and their interactions on the risk of PAOD. METHODS: Two hundred and twenty-two haemodialysis patients (mean age 61.0 ± 11.7 years, 56.8% men) were enrolled and stratified into four groups according to median values of albumin (3.87 g/dL) and logarithm of C-reactive protein (CRP) (0.48 mg/L). Associations between the study groups and an ABI less than 0.9 were assessed using multiple logistic regression analysis. Receiver operating characteristic curves were constructed to predict an ABI less than 0.9. RESULTS: A lower level of albumin and higher level of CRP were significantly associated with an ABI less than 0.9 in multivariate analysis (odds ratio, 5.688; 95% confidence interval, 1.369-23.626; P = 0.017) after adjusting for demographic, clinical, biochemical and medication data. The interaction between albumin and CRP in relation to an ABI less than 0.9 was significant in multivariate analysis (odds ratio, 1.797; 95% confidence interval, 1.258-2.568; P = 0.001). The areas under the curve for albumin, CRP and albumin + CRP for the prediction of ABI less than 0.9 were 0.311, 0.654 and 0.733, respectively. CONCLUSION:Patients undergoing haemodialysis with a lower albumin level and higher CRP level have an increased risk of PAOD. A combination of malnutrition and inflammation may be associated with PAOD in haemodialysis patients.
Authors: Gbenga Akinyosoye; Adaobi U Solarin; Adeyemi Dada; Motunrayo O Adekunle; Alaba B Oladimeji; Adeola O Owolabi; Clement M Akinsola; Barakat A Animasahun; Fidelis O Njokanma Journal: PLoS One Date: 2022-08-11 Impact factor: 3.752