Routinely Measured Serum Biomarkers and Peripheral Artery Disease in Patients Undergoing Maintenance Dialysis: A Systematic Review and Meta-Analysis

IF 1.6 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2027-01-01 Epub Date: 2026-10-05 DOI:10.1016/j.avsg.2026.09.036

Amirhossein Larijani, Aida Hasanzadi, Mokhtar Tazik, Amir Ahmad Sarhandi, Arash Bakhshi, Seyed Mohammad Hossein Mostafavi, Abolfazl Nikkhoy, Saeid Anvari, Mohammad Amin Ashoobi, Mohammad Taghi Ashoobi

{"title":"Routinely Measured Serum Biomarkers and Peripheral Artery Disease in Patients Undergoing Maintenance Dialysis: A Systematic Review and Meta-Analysis","authors":"Amirhossein Larijani, Aida Hasanzadi, Mokhtar Tazik, Amir Ahmad Sarhandi, Arash Bakhshi, Seyed Mohammad Hossein Mostafavi, Abolfazl Nikkhoy, Saeid Anvari, Mohammad Amin Ashoobi, Mohammad Taghi Ashoobi","doi":"10.1016/j.avsg.2026.09.036","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Patients on maintenance dialysis have a markedly elevated prevalence of peripheral artery disease (PAD), which can be independently related to mortality and cardiovascular events. Although routine serum parameters are widely available in dialysis care, the studies comparing them between patients with and without PAD have demonstrated inconsistent results. This systematic review and meta-analysis aims to quantify biomarker differences and resolve the discrepancies.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, unrestricted language searches were performed in PubMed, Scopus, and Web of Science for studies comparing routine serum biomarkers between dialysis patients with and without PAD. Random-effects meta-analyses were conducted for albumin, C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphate, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides to calculate standardized mean difference (SMD) or means ratio. Heterogeneity was explored by meta-regression and sensitivity analyses.</div></div><div><h3>Results</h3><div>Twenty-four studies (33,052 patients; 8,462 with PAD) were included. Serum albumin was significantly lower in PAD patients (SMD: −0.34; 95% CI: −0.48 to −0.20). CRP trended toward elevation without reaching significance. Also, PTH, calcium, phosphate, total cholesterol, LDL, and HDL showed no meaningful differences. Sensitivity analyses and meta-regression confirmed robustness of all estimates. No publication bias was detected.</div></div><div><h3>Conclusion</h3><div>Among routinely measured serum biomarkers, only albumin was significantly associated with PAD in dialysis patients, consistent with the malnutrition-inflammation-atherosclerosis framework. As evidence is predominantly retrospective, these findings reflect correlates of established PAD rather than confirmed predictors of onset, supporting their use to prompt earlier clinical screening. Prospective studies with adjusted analyses are needed to clarify the roles of inflammatory and mineral metabolism markers.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"134 ","pages":"Pages 481-495"},"PeriodicalIF":1.6000,"publicationDate":"2027-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0890509626006862","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/10/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Patients on maintenance dialysis have a markedly elevated prevalence of peripheral artery disease (PAD), which can be independently related to mortality and cardiovascular events. Although routine serum parameters are widely available in dialysis care, the studies comparing them between patients with and without PAD have demonstrated inconsistent results. This systematic review and meta-analysis aims to quantify biomarker differences and resolve the discrepancies.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, unrestricted language searches were performed in PubMed, Scopus, and Web of Science for studies comparing routine serum biomarkers between dialysis patients with and without PAD. Random-effects meta-analyses were conducted for albumin, C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphate, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides to calculate standardized mean difference (SMD) or means ratio. Heterogeneity was explored by meta-regression and sensitivity analyses.

Results

Twenty-four studies (33,052 patients; 8,462 with PAD) were included. Serum albumin was significantly lower in PAD patients (SMD: −0.34; 95% CI: −0.48 to −0.20). CRP trended toward elevation without reaching significance. Also, PTH, calcium, phosphate, total cholesterol, LDL, and HDL showed no meaningful differences. Sensitivity analyses and meta-regression confirmed robustness of all estimates. No publication bias was detected.

Conclusion

Among routinely measured serum biomarkers, only albumin was significantly associated with PAD in dialysis patients, consistent with the malnutrition-inflammation-atherosclerosis framework. As evidence is predominantly retrospective, these findings reflect correlates of established PAD rather than confirmed predictors of onset, supporting their use to prompt earlier clinical screening. Prospective studies with adjusted analyses are needed to clarify the roles of inflammatory and mineral metabolism markers.

查看原文本刊更多论文

维持性透析患者常规测定血清生物标志物和外周动脉疾病：系统回顾和荟萃分析

背景：维持性透析患者外周动脉疾病（PAD）的患病率明显升高，这可能与死亡率和心血管事件独立相关。尽管常规血清参数在透析护理中广泛可用，但在有和没有PAD的患者之间进行比较的研究显示结果不一致。本系统综述和荟萃分析旨在量化生物标志物差异并解决差异。方法：遵循PRISMA指南，在PubMed， Scopus和Web of Science中进行不受限制的语言搜索，以比较有和没有PAD的透析患者的常规血清生物标志物。对白蛋白、CRP、PTH、钙、磷酸盐、总胆固醇、LDL、HDL和甘油三酯进行随机效应荟萃分析，计算标准化平均差（SMD）或平均比。通过meta回归和敏感性分析探讨异质性。结果：纳入了24项研究（33052例患者，其中8462例患有PAD）。PAD患者血清白蛋白显著降低（SMD: -0.34; 95% CI: -0.48至-0.20）。CRP有升高的趋势，但没有达到显著性。PTH、钙、磷酸盐、总胆固醇、LDL和HDL也无显著差异。敏感性分析和元回归证实了所有估计的稳健性。未发现发表偏倚。结论：在常规测量的血清生物标志物中，只有白蛋白与透析患者的PAD显著相关，与营养不良-炎症-动脉粥样硬化框架一致。由于证据主要是回顾性的，这些发现反映了已建立的PAD的相关性，而不是证实的发病预测因素，支持它们用于提示早期临床筛查。需要前瞻性研究和调整分析来阐明炎症和矿物质代谢标志物的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence