Serum malondialdehyde-modified low-density lipoprotein level is a risk factor for peripheral artery disease in patients with stage 3 to 5 chronic kidney disease.

OBJECTIVES: Serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) is a biomarker of oxidative burden and lipid peroxidation that contributes to the development of atherosclerotic cardiovascular diseases. In patients with chronic kidney disease (CKD), both traditional and nontraditional factors increase the risk of vascular calcification and peripheral artery disease (PAD). This cross-sectional study explored the link between serum MDA-LDL and PAD in CKD stages 3-5 patients not receiving dialysis. MATERIALS AND METHODS: Fasting blood specimens and baseline clinical characteristics were collected from CKD stages 3 to 5 patients not receiving dialysis. PAD was diagnosed using ankle-brachial index (ABI), and those with ABI <0.9 were classified into the low ABI group. Serum MDA-LDL levels were quantified with a commercially available enzyme-linked immunosorbent assay kit. RESULTS: Eighteen of the 138 patients (13.0%) had a low ABI. In comparison with the normal ABI group, these patients were significantly older (P = 0.003) and exhibited higher rates of diabetes mellitus (P = 0.034) and current smoking (P = 0.046). In addition, this group showed elevated levels of fasting glucose (P = 0.032), C-reactive protein (P = 0.017), and MDA-LDL (P < 0.001). Pearson correlation analysis showed inverse associations between log-transformed ABI and log-transformed MDA-LDL in the left and right limbs (r = -0.429 and -0.495; both P < 0.001). CONCLUSION: Elevated serum MDA-LDL level was an independent risk factor for PAD in those with CKD stages 3-5 not receiving dialysis.