JET2019

講演情報

Presentation Awards

[L1-3] Presentation Awards
Heat-5 Clinical trials-1

2019年2月22日(金) 13:40 〜 15:10 HallL-1 (Nexus)

Moderators: Norihiko Shinozaki(Tokai University School of Medicine),Taketsugu Tsuchiya(Kanazawa Medical University)
Panelists: Tamon Kato(Shinshu University Hospital),Jun Kikuchi(Gifu heart center)

[MO-27] Association of duration for renal replacement therapy or serum phosphorus level with the prognosis of critical limb ischemia after endovascular therapy.

Naoko Higashino

【Objectives】Patients on hemodialysis (HD) have abnormalities in mineral homeostasis and high serum phosphorus level contributes to atherosclerosis pathogenesis and adverse events. Hemodialysis patients with critical limb ischemia (CLI) has been well recognized as poor prognosis. However, the effect of condition in renal replacement therapy on prognosis has not been systematically studied in these population.

【Methods】This study was retrospective analysis for prospectively maintained database. We recruited 456 hemodialysis patients (age 72.0 ± 10 years, male 67.9%, diabetes 67.9%) with CLI who primarily underwent endovascular therapy (EVT) between January 2007 and December 2016. The outcome measure was amputation-free survival (AFS) and association of duration for renal replacement therapy or serum phosphorus level with AFS was evaluated by Cox proportional hazards regression analysis.

【Results】The average of phosphoric level on admission and dialysis duration were 5.0mg/dL and 8 years. AFS at 1, 3, and 5-year was 73.1%, 46.8%, and 33.7%, respectively. Stratification analysis of AFS according to dialysis condition showed that subgroup with longer duration of dialysis and higher phosphoric level was significantly associated with AFS (hazard ratio: 1.589, 95% confidence interval: 1.057-2.388, p=0.026).

【Conclusions】Longer duration for renal replacement therapy with higher serum phosphorus level was significantly associated with prognosis of hemodialysis patients with CLI after EVT.