[Analysis of clinical state for arteriosclerosis obliterans in lower extremity of diabetic patients on peritoneal dialysis].

Objective: To investigate the prevalence of arteriosclerosis obliterans in lower extremity and its influence factors in diabetic patients on peritoneal dialysis.

Method: In this single center cross-sectional study, 74 with diabetic patients on peritoneal dialysis were recruited. The general information, dialysis program, laboratory examination and dialysis adequacy test results were recorded.Their symptoms and signs of arteriosclerosis obliterans in lower extremities were investigated and ankle brachial index (ABI) was determined.

Result: In this study,70.3% of the patients had different degrees of symptoms and signs of arteriosclerosis obliterans in lower extremity. With Fortaine classification, 13.5% of the patients were in early lesions phase, 28.8% in local ischemic phase, 51.9% in nutritional disturbance phase, and 5.8% in gangrene phase. The patients were divided into three groups base on Fontaine classification: control group (no symptoms), mild group(early lesions phase and local ischemic phase) and severe group(nutritional disturbance phase and gangrene phase). There was a significant difference between the insulin dose, left foot ABI levels, plasma albumin levels and total Kt/V levels among the three groups (P<0.05). The plasma albumin levels and insulin doses were independent factors associated with arteriosclerosis obliterans in lower extremity (P<0.05).

Conclusion: In diabetic patients on peritoneal dialysis, there is a high prevalence of arteriosclerosis obliterans in lower extremity, which is related to high insulin dosage and low serum albumin levels.