Proteinuria and Risk of Lower-Extremity Amputation in Patients With Peripheral Artery Disease

e-Letters: Observations

Diabetes Care 2019 Sep; 42(9): e146-e147. https://doi.org/10.2337/dc19-0764

Article Figures & Tables

Table 1

Adjusted HR (95% CI) of LEA associated with dipstick proteinuria and ACR

Exposure	Events/N	Person-years	HR (95% CI)
Primary cohort: analysis among patients with PAD (N = 4,657); median follow-up 3.5 years (IQI 1.1–6.9 years)
Dipstick proteinuria category			Model 1	Model 2	Model 3
Negative	192/2,596	12,781	Reference	Reference	Reference
Trace	56/539	2,592	1.38 (1.03–1.87)	1.42 (1.05–1.92)	1.32 (0.97–1.78)
1+	77/660	2,553	1.74 (1.34–2.27)	1.61 (1.23–2.11)	1.44 (1.10–1.88)
≥2+	140/862	2,669	2.70 (2.17–3.37)	2.18 (1.69–2.80)	1.70 (1.32–2.19)
P_trend			<0.001	<0.001	<0.001
Secondary cohort: analysis among patients with PAD and diabetes (N = 2,506); median follow-up 4.3 years (IQI 1.6–7.1 years)
ACR, mg/g			Model 1	Model 2	Model 3
ACR <10	47/647	3,674	Reference	Reference	Reference
ACR 10–29	76/604	2,942	1.78 (1.25–2.54)	1.74 (1.22–2.49)	1.47 (1.03–2.11)
ACR 30–300	113/881	3,859	1.96 (1.41–2.71)	1.82 (1.32–2.54)	1.50 (1.07–2.09)
ACR >300	59/374	1,352	2.56 (1.77–3.72)	2.14 (1.43–3.19)	1.61 (1.07–2.43)
P_trend			<0.001	<0.001	0.02

Model 1: adjusted for age, sex, and race. Model 2: model 1 adjustments + baseline year, smoking, hypertension, cardiovascular disease (coronary artery disease, heart failure, or stroke), medication use (renin-angiotensin system inhibitors, antiplatelets, and statins), and eGFR. Model 3: model 2 adjustments + duration of diabetes, diabetic retinopathy, diabetic neuropathy, and HbA_1c (secondary cohort only). IQI, interquartile interval.