Correlation between Albuminuria and Ankle Brachial Index among Nigerians with Chronic Kidney Disease

Abstract

Background: Peripheral arterial disease (PAD), the most common manifestation of atherosclerosis and chronic kidney disease (CKD), has been described as an independent risk factor for its development. The combination of CKD and PAD multiplies the risk of cardiovascular disease. Ankle-brachial pressure index (ABPI) is a good marker of atherosclerosis and is useful for the diagnosis of PAD. The study aimed to determine the prevalence, pattern and predictors of PAD in patients with CKD.

Materials and Methods: This was a cross-sectional study of patients with CKD with age and gender-matched controls. Medical history relating to CKD and PAD was obtained using a pre-tested questionnaire. The ABPI was measured using handheld Doppler ultrasound equipment. Blood samples were drawn for serum creatinine and spot urine for Urinary Albumin Creatinine Ratio (UACR).

Results: One hundred and thirty-two subjects participated in the study, 66 cases and 66 controls. The mean ages were 47.5±15.9 years in cases and 41.6±11.6 years in controls. The mean ABPI (0.9±0.2 vs 1.0±0.1, p-0.01), eGFR (62.8±28.2 vs 98±23.1ml/min/1.73m2 , p-0.01) were lower in the cases compared to the controls while UACR was higher in the cases (3.1±1.1 vs 1.2±0.1, p-0.01. The prevalence of PAD was 36 (54.5%) and 15 (22.7%) among cases and controls, respectively (p < 0.01) while low eGFR OR, 3.9 (1.86-10.41), elevated Systolic blood pressure (SBP) OR, 1.83 (1.40-5.78) and UACR (t-3.663, p-0.023) were associated with PAD in CKD.

Conclusion: This study demonstrated that high prevalence of PAD among individuals with CKD while low eGFR, elevated SBP and microalbuminuria were clinical correlates of PAD in CKD.