CO25 | The prevalence of peripheral artery disease in patients with chronic kidney disease in the Internal Medicine department

S. Marino, G. Fabro, D. Mastroiacovo, A. Bonaventura, F. Dentali | UO Medicina Generale 1, Ospedale di Circolo Fondazione Macchi, Varese, Italy

Premises and Purpose of the study: the prevalence of peripheral artery disease (PAD) in patients with chronic kidney disease (CKD) is probably underestimated, as the accuracy of traditional diagnostic methods is uncertain. This study aims to determine the prevalence of PAD and to evaluate the accuracy of different screening methods in patients with CKD.
Materials and Methods: we enrolled patients >50 years of age, with a diagnosis of CKD (glomerular filtration rate <60 ml/min), hospitalized in the Internal Medicine Department. Patients with a recent (<2 years) diagnosis of CKD and clinically unstable patients were excluded. Each patient was screened using the San Diego Questionnaire, ABI measurement and Doppler wave sound analysis. Furthermore, all patients underwent a full clinical evaluation and a Doppler ultrasound (DUS) to confirm the diagnosis of PAD.
Results: 50 patients were included (30 males, median age 83). Hypertension and dyslipidemia were found in most patients. We estimated a 30% prevalence of PAD (95% CI, 17.8-44.6%) in this population. ABI measurement was associated with a 65% sensitivity (95% CI, 35.1-87.2, p <0.001) and was outperformed by both wave sound analysis (93% sensitivity, 95% CI, 68.1-99.8, p <0.001) and peripheral pulses evaluation (86% sensitivity, 95% CI 59.5-98.3%, p <0.001). Finally, the use of the San Diego Questionnaire had a low accuracy in recognizing patients with PAD.
Conclusions: PAD has a high prevalence among patients with CKD, but the commonly used screening methods underestimate its burden on this population.