Impact of Chronic Kidney Disease on Clinical Outcomes of Endovascular Treatment for Femoropopliteal Arterial Disease.

Autor:	Heideman PP; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Rajebi MR; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., McKusick MA; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Bjarnason H; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Oderich GS; Department of Radiology, Division of Vascular and Endovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Friese JL; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Fleming MD; Department of Radiology, Division of Vascular and Endovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Stockland AH; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Harmsen WS; Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Mandrekar J; Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905., Misra S; Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; Vascular and Interventional Radiology Translational Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address: misra.sanjay@mayo.edu.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2016 Aug; Vol. 27 (8), pp. 1204-14. Date of Electronic Publication: 2016 Jun 16.
DOI:	10.1016/j.jvir.2016.04.036
Abstrakt:	Purpose: To evaluate effect of chronic kidney disease (CKD) on all-cause mortality, major adverse limb event (MALE), MALE and postoperative death (MALE + POD), and amputation after endovascular treatment of femoropopliteal disease. Materials and Methods: A retrospective review from January 2002 to October 2011 was performed of 440 patients who underwent endovascular treatment of symptomatic femoropopliteal disease for claudication (n = 251) or critical limb ischemia (CLI) (n = 267). CKD stage was divided based on Kidney Dialysis Outcomes Quality Initiative classification. Outcomes and factors associated with amputation, MALE, and MALE + POD were determined. Results: Patients with diabetes (hazard ratio [HR] = 2.2; 95% confidence interval [CI], 1.3-3.6; P = .002) and runoff score of 0 or 1 (HR = 2.0; 95% CI, 1.2-3.4; P = .01) relative to runoff score of 3 were at increased risk of amputation. Patients with baseline glomerular filtration rate < 45 mL/min/1.73 m(2) had a 17% increase in amputation for every 5-point decrease < 45 mL/min/1.73 m(2) (95% CI, 1.09-1.26; P < .001). Increase of 10 years in age (HR = 1.9; 95% CI, 1.5-2.3; P < .001), TransAtlantic Inter-Society Consensus class of C/D relative to A/B (HR = 1.6; 95% CI, 1.1-2.2; P = .01), and CLI (HR = 2.4; 95% CI, 0.5-0.9; P < .001) were associated with increased mortality. Female sex was associated with decreased risk of mortality (HR = 0.7; 95% CI, 0.5-0.9; P = .01). Conclusions: Worsening CKD is associated with higher amputation rates, all-cause mortality, and MALE + POD in patients undergoing endovascular treatment of femoropopliteal disease. (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu