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International Journal of Nephrology
Volume 2012, Article ID 385274, 7 pages
http://dx.doi.org/10.1155/2012/385274
Clinical Study

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

1Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
2Department of Clinical Laboratory, Oyokyo Kidney Research Institute, Hirosaki 036-8243, Japan
3Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
4Department of Urology, Oyokyo Kidney Research Institute, Hirosaki 036-8243, Japan

Received 3 December 2011; Accepted 30 January 2012

Academic Editor: David B. Kershaw

Copyright © 2012 Shingo Hatakeyama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.