Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis
Lower limbs’ arterial calcification is significantly associated with the clinical severity of lower extremity artery disease (LEAD) in patients undergoing hemodialysis (HD). However, the association between arterial calcification of the lower limbs and long-term clinical outcomes in patients on HD h...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/4/1299 |
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| author | Takayasu Ohtake Ayaka Mitomo Mizuki Yamano Toshihiro Shimizu Yasuhiro Mochida Kunihiro Ishioka Machiko Oka Kyoko Maesato Hidekazu Moriya Sumi Hidaka Milanga Mwanatambwe Shuzo Kobayashi |
| author_facet | Takayasu Ohtake Ayaka Mitomo Mizuki Yamano Toshihiro Shimizu Yasuhiro Mochida Kunihiro Ishioka Machiko Oka Kyoko Maesato Hidekazu Moriya Sumi Hidaka Milanga Mwanatambwe Shuzo Kobayashi |
| author_sort | Takayasu Ohtake |
| collection | DOAJ |
| description | Lower limbs’ arterial calcification is significantly associated with the clinical severity of lower extremity artery disease (LEAD) in patients undergoing hemodialysis (HD). However, the association between arterial calcification of the lower limbs and long-term clinical outcomes in patients on HD has not been elucidated. Calcification scores of the superficial femoral artery (SFACS) and below-knee arteries (BKACS) were quantitatively evaluated in 97 HD patients who were followed for 10 years. Clinical outcomes, including all-cause and cardiovascular mortality, cardiovascular events, and limb amputation were evaluated. Risk factors for clinical outcomes were evaluated using univariate and multivariate Cox proportional hazard analyses. Furthermore, SFACS and BKACS were divided into three groups (low, middle, and high), and their associations with clinical outcomes were evaluated using Kaplan–Meier analysis. SFACS, BKACS, C-reactive protein, serum albumin, age, diabetes, presence of ischemic heart disease, and critical limb-threatening ischemia were significantly associated with 3-year and 10-year clinical outcomes in the univariate analysis. Multivariate analysis showed that SFACS was an independent factor associated with 10-year cardiovascular events and limb amputations. Kaplan–Meier life table analysis showed that higher SFACS and BKACS levels were significantly associated with cardiovascular events and mortality. In conclusion, long-term clinical outcomes and the risk factors in patients undergoing HD were evaluated. Arterial calcification of the lower limbs was strongly associated with 10-year cardiovascular events and mortality in patients undergoing HD. |
| first_indexed | 2024-03-11T08:38:48Z |
| format | Article |
| id | doaj.art-7fc33ae068e447fca15a4a30036c7a40 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T08:38:48Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7fc33ae068e447fca15a4a30036c7a402023-11-16T21:17:38ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124129910.3390/jcm12041299Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on HemodialysisTakayasu Ohtake0Ayaka Mitomo1Mizuki Yamano2Toshihiro Shimizu3Yasuhiro Mochida4Kunihiro Ishioka5Machiko Oka6Kyoko Maesato7Hidekazu Moriya8Sumi Hidaka9Milanga Mwanatambwe10Shuzo Kobayashi11Department of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Nephrology, Tokyo Nishi Tokushukai Hospital, Tokyo 196-0003, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanDepartment of Pathology, University of Mbuji Mayi, Mbujimayi 433, CongoDepartment of Kidney and Transplant Center, Shonan Kamakura General Hospital, Kamakura 247-8533, JapanLower limbs’ arterial calcification is significantly associated with the clinical severity of lower extremity artery disease (LEAD) in patients undergoing hemodialysis (HD). However, the association between arterial calcification of the lower limbs and long-term clinical outcomes in patients on HD has not been elucidated. Calcification scores of the superficial femoral artery (SFACS) and below-knee arteries (BKACS) were quantitatively evaluated in 97 HD patients who were followed for 10 years. Clinical outcomes, including all-cause and cardiovascular mortality, cardiovascular events, and limb amputation were evaluated. Risk factors for clinical outcomes were evaluated using univariate and multivariate Cox proportional hazard analyses. Furthermore, SFACS and BKACS were divided into three groups (low, middle, and high), and their associations with clinical outcomes were evaluated using Kaplan–Meier analysis. SFACS, BKACS, C-reactive protein, serum albumin, age, diabetes, presence of ischemic heart disease, and critical limb-threatening ischemia were significantly associated with 3-year and 10-year clinical outcomes in the univariate analysis. Multivariate analysis showed that SFACS was an independent factor associated with 10-year cardiovascular events and limb amputations. Kaplan–Meier life table analysis showed that higher SFACS and BKACS levels were significantly associated with cardiovascular events and mortality. In conclusion, long-term clinical outcomes and the risk factors in patients undergoing HD were evaluated. Arterial calcification of the lower limbs was strongly associated with 10-year cardiovascular events and mortality in patients undergoing HD.https://www.mdpi.com/2077-0383/12/4/1299lower extremity artery diseasehemodialysislimb amputationcardiovascular eventarterial calcification |
| spellingShingle | Takayasu Ohtake Ayaka Mitomo Mizuki Yamano Toshihiro Shimizu Yasuhiro Mochida Kunihiro Ishioka Machiko Oka Kyoko Maesato Hidekazu Moriya Sumi Hidaka Milanga Mwanatambwe Shuzo Kobayashi Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis Journal of Clinical Medicine lower extremity artery disease hemodialysis limb amputation cardiovascular event arterial calcification |
| title | Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis |
| title_full | Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis |
| title_fullStr | Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis |
| title_full_unstemmed | Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis |
| title_short | Impact of Arterial Calcification of the Lower Limbs on Long-Term Clinical Outcomes in Patients on Hemodialysis |
| title_sort | impact of arterial calcification of the lower limbs on long term clinical outcomes in patients on hemodialysis |
| topic | lower extremity artery disease hemodialysis limb amputation cardiovascular event arterial calcification |
| url | https://www.mdpi.com/2077-0383/12/4/1299 |
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