Skin perfusion pressure in lower extremities at haemodialysis initiation is associated with 1-year mortality and cardiovascular disease.

BACKGROUND

Skin perfusion pressure (SPP) is a noninvasively obtained and useful measurement for assessing peripheral arterial disease (PAD). Decreased SPP in lower extremities is associated with poor survival in maintenance haemodialysis (HD) patients. Nevertheless, the prognostic significance of SPP at HD initiation has not been determined. We investigated the relation between SPP and death or cardiovascular disease (CVD) in incident HD patients.

METHODS

Data were collected retrospectively from patients with SPP measurements taken by dialysis nurses at HD initiation during 2020-2023. Then we assessed the association between the minimum value of SPP in the bilateral dorsal/plantar portions of each patient (SPPmin) and outcomes, consisting of mortality and CVDs within 1 year after HD initiation.

RESULTS

This study examined 104 incident HD patients with a median age of 74 (79% male). Based on the suggested cut-off value from receiver operating characteristic analysis, patients were divided into two groups: patients with SPPmin ≥ 60 mmHg (higher SPPmin) and those with SPPmin < 60 mmHg (lower SPPmin). Kaplan-Meier analysis indicated the 1-year survival and CVD-free rate as significantly lower in the lower SPPmin group than in the higher SPPmin group (p < .001). Cox proportional hazards analyses showed lower SPPmin as associated with the composite outcome. The relation between lower SPPmin and outcome held true in each subgroup with cardiovascular risk such as older age and history of CVD.

CONCLUSION

SPP measured by dialysis nurses at HD initiation is associated with 1-year adverse outcomes in incident HD patients.