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In-hospital outcome of peripheral vascular intervention in dialysis-dependent end-stage renal disease patients.




BACKGROUND: The impact of end-stage renal disease (ESRD) on peripheral vascular intervention (PVI) outcome remains incompletely elucidated. OBJECTIVES: We sought to compare the outcome of PVI in dialysis patients with those with normal kidney function. METHODS: Using weighted data from the National Inpatient Sample database between 2002 and 2014, we identified all peripheral artery disease (PAD) patients aged =18?years that underwent PVI. Multivariate logistic regression analysis was performed to examine in-hospital outcomes. RESULTS: Of 1,186,192 patients who underwent PVI, 1,066,830 had normal kidney function (89.9%) and 119,362 had ESRD requiring dialysis (10.1%). Critical limb ischemia was more prevalent in dialysis patients (63.2 vs. 34.0%, p <?.001). Compared with normal kidney function group, ESRD requiring dialysis was associated with higher in-hospital mortality (1.5 vs. 4.2%, adjusted OR: 2.13 [95% CI: 2.04-2.23]) and longer length of hospital stay (median 3?days, Interquartile range [IQR] (0-6) vs. 7?days, IQR (4-18); p <?.001). Dialysis patients had higher incidence of major adverse cardiovascular events (composite of death, myocardial infarction, or stroke; 14.3 vs. 9.8%, p <?.001) and net adverse cardiovascular events (composite of MACE, major bleeding, or vascular complications; 40.8 vs. 29.1%, p <?.001). ESRD patients less frequently underwent open bypass (5.6 vs. 8.5%, p <?.001) and more frequently had major amputation (10.3 vs. 3.0%, p <?.001) compared with normal kidney function group. CONCLUSION: PAD patients on dialysis who underwent PVI have higher rates of mortality and adverse outcomes as compared to those with normal kidney function.

Acceptance Date Sep 17, 2019
Publication Date Feb 15, 2020
Journal Catheter Cardiovasc Interv
Pages E84 - E95
Keywords end-stage renal disease; endovascular intervention; peripheral artery disease