The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study
Objective: The current study aimed to determine the relationship between chronic kidney disease (CKD) and major 12-month outcomes for patients with in-hospital treatment for symptomatic peripheral arterial occlusive disease (PAOD). Methods: An analysis of the prospective longitudinal multicentric co...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4750 |
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| author | Artur Kotov Deven A. Blasche Frederik Peters Philip Pospiech Ulrich Rother Konstantinos Stavroulakis Jürgen Remig Christian Schmidt-Lauber Thomas Zeller Hartmut Görtz Jörg Teßarek Christian-Alexander Behrendt |
| author_facet | Artur Kotov Deven A. Blasche Frederik Peters Philip Pospiech Ulrich Rother Konstantinos Stavroulakis Jürgen Remig Christian Schmidt-Lauber Thomas Zeller Hartmut Görtz Jörg Teßarek Christian-Alexander Behrendt |
| author_sort | Artur Kotov |
| collection | DOAJ |
| description | Objective: The current study aimed to determine the relationship between chronic kidney disease (CKD) and major 12-month outcomes for patients with in-hospital treatment for symptomatic peripheral arterial occlusive disease (PAOD). Methods: An analysis of the prospective longitudinal multicentric cohort study with 12-month follow-up was conducted including patients who underwent endovascular or open surgery for symptomatic PAOD at 35 German vascular centres (initial study protocol: NCT03098290). Severity of CKD was grouped into four stages combining information about the estimated glomerular filtration rate (eGFR) at baseline and dialysis dependency. Outcomes included overall mortality as well as the two composite endpoints of amputation or death, and of major cardiovascular events (MACE). 12-month incidences and adjusted hazard ratios were estimated using the Kaplan–Meier function and Cox proportional hazard models. Results: A total of 4354 patients (32% female, 69 years mean age, 68% intermittent claudication, 69% percutaneous endovascular revascularisation) were included and followed for 244 days in median. Thereof, 22% had any CKD and 5% had end stage kidney disease (ESKD) at baseline. The 12-month overall mortality rate was 3.6% (95% CI 2.3–4.9) with 96 events in the entire cohort: 147 were amputated or died (5.3%, 95% CI 5.2–5.3), and 277 had a MACE (9.5%, 95% CI 9.4–9.5). When compared with patients without kidney disease, ESKD was significantly associated with overall mortality (HR 1.9; 95% CI 1.1–3.5), amputation or death (HR 2.4; 95% CI 1.4–4.1), and MACE (HR 2.0; 95% CI 1.3–3.2). Conclusions: In the current study on mid-term outcomes after invasive revascularisation for symptomatic PAOD, one out of five patients suffered from any CKD while those few with ESKD had twice the odds of death, of amputation or death, and of major adverse cardiovascular events after twelve months. These results emphasise that concomitant CKD and its impact on outcomes should be considered by severity while mild and moderate grades should not lead to ineffectual treatment strategies. |
| first_indexed | 2024-03-09T09:55:12Z |
| format | Article |
| id | doaj.art-3cba46e2d56a42bba4f7b2ead9de7cf6 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:55:12Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-3cba46e2d56a42bba4f7b2ead9de7cf62023-12-01T23:50:22ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116475010.3390/jcm11164750The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort StudyArtur Kotov0Deven A. Blasche1Frederik Peters2Philip Pospiech3Ulrich Rother4Konstantinos Stavroulakis5Jürgen Remig6Christian Schmidt-Lauber7Thomas Zeller8Hartmut Görtz9Jörg Teßarek10Christian-Alexander Behrendt11Research Group GermanVasc, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyResearch Group GermanVasc, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyResearch Group GermanVasc, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyResearch Group GermanVasc, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Vascular Surgery, University Medical Centre Erlangen, 91054 Erlangen, GermanyCommission on Peripheral Artery Disease and Diabetic Foot Syndrome, German Society for Vascular Surgery and Vascular Medicine, 10115 Berlin, GermanyBonn Community Hospital, Haus St. Petrus, 53113 Bonn, GermanyIII. Department of Medicine, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyClinic for Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, 79189 Bad Krozingen, GermanyCommission on Peripheral Artery Disease and Diabetic Foot Syndrome, German Society for Vascular Surgery and Vascular Medicine, 10115 Berlin, GermanySt. Boniface Hospital Lingen, 49808 Lingen, GermanyResearch Group GermanVasc, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyObjective: The current study aimed to determine the relationship between chronic kidney disease (CKD) and major 12-month outcomes for patients with in-hospital treatment for symptomatic peripheral arterial occlusive disease (PAOD). Methods: An analysis of the prospective longitudinal multicentric cohort study with 12-month follow-up was conducted including patients who underwent endovascular or open surgery for symptomatic PAOD at 35 German vascular centres (initial study protocol: NCT03098290). Severity of CKD was grouped into four stages combining information about the estimated glomerular filtration rate (eGFR) at baseline and dialysis dependency. Outcomes included overall mortality as well as the two composite endpoints of amputation or death, and of major cardiovascular events (MACE). 12-month incidences and adjusted hazard ratios were estimated using the Kaplan–Meier function and Cox proportional hazard models. Results: A total of 4354 patients (32% female, 69 years mean age, 68% intermittent claudication, 69% percutaneous endovascular revascularisation) were included and followed for 244 days in median. Thereof, 22% had any CKD and 5% had end stage kidney disease (ESKD) at baseline. The 12-month overall mortality rate was 3.6% (95% CI 2.3–4.9) with 96 events in the entire cohort: 147 were amputated or died (5.3%, 95% CI 5.2–5.3), and 277 had a MACE (9.5%, 95% CI 9.4–9.5). When compared with patients without kidney disease, ESKD was significantly associated with overall mortality (HR 1.9; 95% CI 1.1–3.5), amputation or death (HR 2.4; 95% CI 1.4–4.1), and MACE (HR 2.0; 95% CI 1.3–3.2). Conclusions: In the current study on mid-term outcomes after invasive revascularisation for symptomatic PAOD, one out of five patients suffered from any CKD while those few with ESKD had twice the odds of death, of amputation or death, and of major adverse cardiovascular events after twelve months. These results emphasise that concomitant CKD and its impact on outcomes should be considered by severity while mild and moderate grades should not lead to ineffectual treatment strategies.https://www.mdpi.com/2077-0383/11/16/4750chronic kidney diseaseend-stage kidney diseaselower extremity artery diseaseintermittent claudicationchronic limb-threatening ischaemiaopen and endovascular revascularisation |
| spellingShingle | Artur Kotov Deven A. Blasche Frederik Peters Philip Pospiech Ulrich Rother Konstantinos Stavroulakis Jürgen Remig Christian Schmidt-Lauber Thomas Zeller Hartmut Görtz Jörg Teßarek Christian-Alexander Behrendt The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study Journal of Clinical Medicine chronic kidney disease end-stage kidney disease lower extremity artery disease intermittent claudication chronic limb-threatening ischaemia open and endovascular revascularisation |
| title | The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study |
| title_full | The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study |
| title_fullStr | The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study |
| title_full_unstemmed | The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study |
| title_short | The Impact of Chronic Kidney Disease on Mid-Term Outcomes after Revascularisation of Peripheral Arterial Occlusive Disease: Results from a Prospective Cohort Study |
| title_sort | impact of chronic kidney disease on mid term outcomes after revascularisation of peripheral arterial occlusive disease results from a prospective cohort study |
| topic | chronic kidney disease end-stage kidney disease lower extremity artery disease intermittent claudication chronic limb-threatening ischaemia open and endovascular revascularisation |
| url | https://www.mdpi.com/2077-0383/11/16/4750 |
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