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Albuminuria Is the Stronger Risk Factor for Peripheral Arterial Disease than eGFR Decline in a Type 2 Diabetic Taiwanese Population

Background: Several studies have shown the identified risk factors for peripheral arterial disease in individuals with diabetes, but relatively little information has been provided regarding the risk factors for peripheral arterial disease especially in individuals with renal insufficiency and albuminuria. Aims: In our study, we attempted to determine whether peripheral arterial disease is related to the reduction of estimated glomerular filtration rate (eGFR) or albuminuria in type 2 diabetic patients if both were measured. Methods: We included 478 type 2 diabetic patients that were more than 50 years old in this study and determined their urine albumin to creatinine ratio and eGFR. The ankle-brachial index was measured. Results: We found a prevalence of peripheral arterial disease of 12 and 11.7% in the normoalbuminuria and >90 ml/min/1.73 m2 eGFR group. Simple logistic regression analysis showed that both macroalbuminuria and eGFR <60 ml/min/1.73 m2 were significantly associated with peripheral arterial disease individually, but most interestingly in the multiple logistic regression analysis, macroalbuminuria and age are independent factors for peripheral arterial disease with a p value of 0.012 (β = 1.014) and <0.001 (β = 0.107), respectively. Conclusion: In summary, our study indicates that macroalbuminuria is a stronger indicator for peripheral arterial disease than eGFR <60 ml/min/1.73 m2 in a type 2 diabetic population older than 50 years of age.