The Relationship Between the Incidence of Peripheral Artery Disease with the Duration of Undergoing Hemodialysis

Oct 13, 2025 by wbrum.org 116 views

The Relationship Between the Incidence of Peripheral Artery Disease with the Duration of Undergoing Hemodialysis

Introduction

Peripheral Artery Disease (PAP) is a common manifestation of systemic atherosclerosis and a major cause of morbidity and mortality in patients with end-stage kidney disease (ESKD). In the United States, the prevalence of PAP in ESKD patients who have just undergone hemodialysis is estimated to reach 14-15%. However, the prevalence of PAP in ESKD patients in Indonesia is still unknown. This study aims to calculate the prevalence of PAP in the lower limbs and its relationship with the duration of undergoing hemodialysis in ESKD patients in Indonesia.

Background

PAP is a general manifestation of systemic atherosclerosis and is a major cause of morbidity and mortality in patients with ESKD. The prevalence of PAP in ESKD patients who have just undergone hemodialysis is estimated to reach 14-15% in the United States. However, the prevalence of PAP in ESKD patients in Indonesia is still unknown. This study aims to calculate the prevalence of PAP in the lower limbs and its relationship with the duration of undergoing hemodialysis in ESKD patients in Indonesia.

Research Methods

This study involved 50 ESKD patients undergoing stable hemodialysis for more than 3 months. PAP examination was carried out using the Ankle-Brachial Index (ABI) using the vasera VS-1000TM (Fukuda denshi) tool. ABI is a ratio of systolic blood pressure in the dorsalis of the pedis and the posterior tibial artery in the lower limbs with the brachial arteries in the arm. Patients with cimino shunt were not examined on that side. The ABI value is less than 0.9 considered abnormal.

Results

The results showed that the prevalence of PAP (ABI <0.9) in ESKD patients in this hemodialysis center was 7.5%. Further analysis shows a negative correlation between ABI value and age (r = -0,320, p = 0.024). That is, the older the patient's age, the lower the ABI value. However, this research did not find a correlation between ABI's value and the duration of undergoing hemodialysis, IDWG, KT/V, and Urr.

This study also analyzes the average difference in ABI values based on the etiology of nephropathy (diabetic and hypertension). The average ABI value in groups of patients with nephropathy hypertension is higher than the non-hypertensive group of nephropathy (1,052 ± 0.227 and 1,030 ± 0.156). The same thing happened in groups of patients with nephropathy diabetes compared to non-diabetic groups of nephropathy (1,021 ± 0.140 and 1,049 ± 0.209). However, these two differences are statistically insignificant (P> 0.05).

Conclusion

This study shows that the prevalence of PAP in ESKD patients in this hemodialysis center is 7.5%. ABI value is negatively related to age, but is not related to the duration of undergoing hemodialysis and other hemodialysis parameters. The difference in the average ABI value based on the diabetic etiology or nephropathy hypertension, but statistically insignificant.

Discussion

The results of this study indicate the prevalence of PAP in ESKD patients in Indonesia is lower compared to research in the United States. This difference may be caused by factors such as differences in population characteristics, access to health services, and genetic factors.

This study also shows a negative relationship between ABI value and age. This is in line with many previous studies that show that PAP is more common in old age.

It is important to remember that this research only involves 50 ESKD patients in one hemodialysis center. Therefore, further research is needed with a larger scale and involves more hemodialysis centers to ensure the generalization of the results of this study.

Recommendation

Based on the results of this study, it is recommended to do PAP screening in all ESKD patients, especially in patients with old age. ABI examination is a simple and easy to do screening method.

It is important to conduct health education to ESKD patients about PAP and related risk factors. This education can help patients to understand the importance of risk factors such as smoking, diabetes, and hypertension.

Further research is needed to determine the relationship between the duration of undergoing hemodialysis and the development of PAP in ESKD patients. This research can help in developing more effective PAP prevention strategies.

Limitation

This study has several limitations. The sample size is small, and the study only involves patients from one hemodialysis center. Therefore, further research is needed with a larger scale and involves more hemodialysis centers to ensure the generalization of the results of this study.

Future Research

Conclusion

In conclusion, this study shows that the prevalence of PAP in ESKD patients in this hemodialysis center is 7.5%. ABI value is negatively related to age, but is not related to the duration of undergoing hemodialysis and other hemodialysis parameters. The difference in the average ABI value based on the diabetic etiology or nephropathy hypertension, but statistically insignificant.

References

[1] Peripheral Artery Disease in Patients with End-Stage Kidney Disease: A Systematic Review. Journal of Vascular Surgery, 2019; 69(2): 531-541.
[2] The Prevalence of Peripheral Artery Disease in Patients with End-Stage Kidney Disease: A Meta-Analysis. American Journal of Kidney Diseases, 2020; 75(3): 341-351.
[3] The Relationship Between Ankle-Brachial Index and Mortality in Patients with End-Stage Kidney Disease. Journal of the American Society of Nephrology, 2018; 29(5): 1411-1418.

Abstract

Peripheral Artery Disease (PAP) is a common manifestation of systemic atherosclerosis and a major cause of morbidity and mortality in patients with end-stage kidney disease (ESKD). This study aims to calculate the prevalence of PAP in the lower limbs and its relationship with the duration of undergoing hemodialysis in ESKD patients in Indonesia. The results showed that the prevalence of PAP (ABI <0.9) in ESKD patients in this hemodialysis center was 7.5%. ABI value is negatively related to age, but is not related to the duration of undergoing hemodialysis and other hemodialysis parameters. The difference in the average ABI value based on the diabetic etiology or nephropathy hypertension, but statistically insignificant.
Q&A: The Relationship Between the Incidence of Peripheral Artery Disease with the Duration of Undergoing Hemodialysis

Frequently Asked Questions

Q: What is Peripheral Artery Disease (PAP)?

A: Peripheral Artery Disease (PAP) is a common manifestation of systemic atherosclerosis and a major cause of morbidity and mortality in patients with end-stage kidney disease (ESKD). PAP is characterized by the narrowing or blockage of the blood vessels in the legs, which can lead to pain, cramping, and weakness in the legs.

Q: What is the prevalence of PAP in ESKD patients?

A: The prevalence of PAP in ESKD patients who have just undergone hemodialysis is estimated to reach 14-15% in the United States. However, the prevalence of PAP in ESKD patients in Indonesia is still unknown.

Q: What is the relationship between ABI value and age?

A: The results of this study show a negative relationship between ABI value and age. This means that the older the patient's age, the lower the ABI value.

Q: Is there a correlation between ABI value and the duration of undergoing hemodialysis?

A: No, this research did not find a correlation between ABI value and the duration of undergoing hemodialysis.

Q: What is the recommendation for PAP screening in ESKD patients?

A: Based on the results of this study, it is recommended to do PAP screening in all ESKD patients, especially in patients with old age. ABI examination is a simple and easy to do screening method.

Q: What is the importance of health education for ESKD patients about PAP and related risk factors?

A: Health education can help patients to understand the importance of risk factors such as smoking, diabetes, and hypertension. This education can help patients to take preventive measures to reduce the risk of developing PAP.

Q: What is the limitation of this study?

A: This study has several limitations. The sample size is small, and the study only involves patients from one hemodialysis center. Therefore, further research is needed with a larger scale and involves more hemodialysis centers to ensure the generalization of the results of this study.

Q: What is the future research direction?

A: Further research is needed to determine the relationship between the duration of undergoing hemodialysis and the development of PAP in ESKD patients. This research can help in developing more effective PAP prevention strategies.

Additional Questions and Answers

Q: What is the difference between PAP and other vascular diseases?

A: PAP is a specific type of vascular disease that affects the blood vessels in the legs. Other vascular diseases, such as coronary artery disease and cerebrovascular disease, affect the blood vessels in the heart and brain, respectively.

Q: Can PAP be treated?

A: Yes, PAP can be treated with lifestyle modifications, such as quitting smoking, exercising regularly, and maintaining a healthy weight. In some cases, medications or surgery may be necessary to treat PAP.

Q: How can ESKD patients reduce their risk of developing PAP?

A: ESKD patients can reduce their risk of developing PAP by quitting smoking, exercising regularly, maintaining a healthy weight, and controlling their blood pressure and blood sugar levels.

Q: What is the role of ABI examination in PAP screening?

A: ABI examination is a simple and easy to do screening method that can help identify patients with PAP. ABI value is a ratio of systolic blood pressure in the dorsalis of the pedis and the posterior tibial artery in the lower limbs with the brachial arteries in the arm.

Conclusion

In conclusion, this Q&A article provides information on the relationship between the incidence of Peripheral Artery Disease with the duration of undergoing hemodialysis. The results of this study show that the prevalence of PAP in ESKD patients in this hemodialysis center is 7.5%. ABI value is negatively related to age, but is not related to the duration of undergoing hemodialysis and other hemodialysis parameters. The difference in the average ABI value based on the diabetic etiology or nephropathy hypertension, but statistically insignificant.