Longterm Outcomes of the Screening and Management of Peripheral Arterial Occlusive Disease (PAOD) in End Stage of Renal Disease (ESRD) Patients

The mortality and hospitalization of hemodialysis patients with peripheral arterial occlusive disease (PAOD) are significantly higher than those hemadialysis without PAOD complication. Also, PAOD is the major cause of amputation for the end stage of renal disease (ESRD) patients. The prevalence of PAOD in Taiwan is 27.8% that is lower then 25.3% in UAS. However, there is no regular assessment of PAOD in clinics. This study is a three-year longitudinal follow-up design. The major purposes of this study are: to establish effective PAOD screening tools, to identify the prevalence of PAOD per 6 months, and to validate the short and long-term outcomes of walking program in related to the prevention and management of PAOD. In the first year, we select Ankle-brachial index (ABI), Oxyhemoglobin saturation by pulse oximetry (SpO2), The Edinburgh Claudication Questionnaire (ECQ), and local temperature to identify the prevalence of PAOD in both 800 hemodialysis patients and 300 CAPD patients. The focus of the second and third year is to validate the outcomes of walking program on the prevention and management of PAOD in 100 hemodialysis patients and 60 CAPD patients. Descriptive statistic analysis such as: frequency, percentage, mean, standard deviation, minimum and maximum is used to describe the basic condition of each variable. The inferral statistics such as student t test, ANOVA, Chi-Square, and Pearson correlation is selected to identify the expected relationship. The sensitivity, specificity, likelihood ratios and ROC curve are performed to identify the effectiveness of screening tools. Meanwhile, logistic regression, multiple regression, and GEE will be performed to identify the predictors and long-term outcomes If an effective screening tool can be established by present study, a regular screening program for PAOD could help the health team evaluate the circulation of local vessels. It can help the patients with PAOD complication receive treatments as early as possible. Then, a failure of treatment and unnecessary medical expenditure will be reduced. Finally, a better quality of life of the ESRD patients will be promoted.

Project ID:PC9709-1229
External Project ID:NSC97-2314-B182-027