PMID- 33583873
OWN - NLM
STAT- MEDLINE
DCOM- 20220318
LR  - 20220325
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Print)
IS  - 1340-3478 (Linking)
VI  - 29
IP  - 3
DP  - 2022 Mar 1
TI  - Impact of Longer Hemodialysis Vintage with Higher Serum Phosphorus Level on 
      Clinical Outcomes in Patients with Chronic Limb-Threatening Ischemia Presenting 
      Tissue Loss after Endovascular Therapy.
PG  - 370-378
LID - 10.5551/jat.60095 [doi]
AB  - AIMS: Hemodialysis vintage and serum phosphorus levels adversely affect outcomes 
      in patients on hemodialysis. Whether these factors have a similar prognostic 
      impact on patients who are on hemodialysis and have chronic limb-threatening 
      ischemia (CLTI) has not been systematically studied. We aimed to explore the risk 
      factors, including hemodialysis vintage and serum phosphorus levels, on clinical 
      outcomes after endovascular therapy (EVT) in hemodialysis patients with CLTI. 
      METHODS: The current study rerospectively analyzed 374 hemodialysis patients with 
      CLTI presenting with ischemic tissue loss (age: 72.3+/-9.0 years, male: 73.3%, 
      diabetes mellitus: 68.2%, Rutherford 5: 75.9%, 6: 24.1%, WIfI stage 4: 50.0%) 
      primarily treated with EVT between April 2007 and December 2016. The primary 
      outcome measure was 1-year amputation-free survival (AFS), while the secondary 
      outcome measure was 1-year wound healing. Predictors for each outcome were 
      evaluated by Cox proportional hazards model. RESULTS: Multivariate analysis 
      significantly associated longer hemodialysis vintages with higher serum 
      phosphorus levels (hazard ratio [HR], 0.599; 95% confidence interval [CI], 
      0.394-0.910; p=0.016) with 1-year AFS. Longer vintages for hemodialysis with 
      higher serum phosphorus levels were marginally, but not significantly, associated 
      with 1-year wound healing. (HR, 0.684; 95% CI, 0.467-1.000; p=0.050). CONCLUSION: 
      Longer hemodialysis vintages with higher serum phosphorus levels adversely affect 
      outcomes after EVT for hemodialysis patients with CLTI presenting with ischemic 
      tissue loss.
FAU - Higashino, Naoko
AU  - Higashino N
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Iida, Osamu
AU  - Iida O
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Hata, Yosuke
AU  - Hata Y
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Asai, Mitsutoshi
AU  - Asai M
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Masuda, Masaharu
AU  - Masuda M
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Okamoto, Shin
AU  - Okamoto S
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Ishihara, Takayuki
AU  - Ishihara T
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Nanto, Kiyonori
AU  - Nanto K
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Kanda, Takashi
AU  - Kanda T
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Tsujimura, Takuya
AU  - Tsujimura T
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Okuno, Shota
AU  - Okuno S
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Matsuda, Yasuhiro
AU  - Matsuda Y
AD  - Kansai Rosai Hospital Cardiovascular Center.
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Metabolic Medicine and Department of Diabetes Care Medicine, Osaka 
      University Graduate School of Medicine.
FAU - Mano, Toshiaki
AU  - Mano T
AD  - Kansai Rosai Hospital Cardiovascular Center.
LA  - eng
PT  - Journal Article
DEP - 20210214
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
RN  - 27YLU75U4W (Phosphorus)
SB  - IM
MH  - Aged
MH  - Chronic Limb-Threatening Ischemia/blood/epidemiology/*etiology
MH  - Endovascular Procedures/*adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Japan/epidemiology
MH  - Male
MH  - Phosphorus/*blood
MH  - Renal Dialysis
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Time Factors
PMC - PMC8894118
OTO - NOTNLM
OT  - Amputation-free survival (AFS)
OT  - Chronic limb-threatening ischemia (CLTI)
OT  - Hemodialysis vintage
OT  - Serum phosphorus level
OT  - Wound healing
EDAT- 2021/02/16 06:00
MHDA- 2022/03/19 06:00
PMCR- 2022/03/01
CRDT- 2021/02/15 06:05
PHST- 2021/02/16 06:00 [pubmed]
PHST- 2022/03/19 06:00 [medline]
PHST- 2021/02/15 06:05 [entrez]
PHST- 2022/03/01 00:00 [pmc-release]
AID - DN/JST.JSTAGE/jat/60095 [pii]
AID - 10.5551/jat.60095 [doi]
PST - ppublish
SO  - J Atheroscler Thromb. 2022 Mar 1;29(3):370-378. doi: 10.5551/jat.60095. Epub 2021 
      Feb 14.