Peripheral Arterial Disease among End-Stage Renal Disease Patients

Aim of Study: To explore risk factors for PAD among ESRD patients in Aseer Region, Kingdom of Saudi Arabia. Patients and Methods: This is a cross-sectional study, which has been conducted during the period from January till December 2012. It included 99 end-stage renal disease (ESRD) cases on hemodialysis attending the Nephrology Unit and Vascular and Endovascular Surgery Department of Aseer Central Hospital, Abha City, Kingdom of Saudi Arabia. The ankle brachial index (ABI) ratio was calculated for every patient. A criterion for the diagnosis of PAD was an ABI 0.9. A lower-extremity angiogram had been performed in all patients. Patients were classified as having PAD if they have any of the two following criteria: A positive ABI in either leg, or a positive lower-extremity angiogram. Not satisfactory. Results: Most patients were hypertensive (62.6%), while 34.3% were diabetic and 7.1% were hyperlipidemic. Peripheral arterial disease was diagnosed in 26.3% of patients, whose manifestations were mainly intermittent claudication (21.2%), with 2% experiencing rest pain and 3% developed gangrene. Prevalence of PAD among ESRD patients undergoing hemodialysis was progressively and significantly higher with older age groups and with longer durations of hemodialysis. PAD was significantly more prevalent among diabetics. Prevalence of PAD was significantly higher among smokers. Prevalence of PAD did not differ according patient s gender, hypertension or hyperlipidemia. Conclusions: Prevalence of PAD among ESRD patients undergoing hemodialysis is high. Risk factors for PAD include patient’s older age, smoking, diabetes and longer duration of hemodialysis. ABI for ESRD patients on hemodialysis should be regularly assessed.