Search Results (224)

Background/Objectives: Impairment in self-awareness (ISA) is one of the common consequences of an acquired brain injury (ABI) and is associated with anosodiaphoria. Collectively, these co-occurring neuropsychological disorders pose significant obstacles in the neurorehabilitation of moderate-to-severe ABI patients. Individuals who recover from ISA may present with anxiety and/or depression as adaptive reactions to the ABI, along with related functional disabilities. The present study investigated whether the level of metacognitive self-awareness (SA) is associated with the presence of anxiety and depression, apathy, or anosodiaphoria in patients with moderate-to-severe ABI. It aimed also at investigating the possible relationship between the severity of disability and both psycho-emotional diseases and the presence of PTSD symptoms in patients with high metacognitive SA. Methods: Sixty patients with moderate-to-severe ABI and different levels of metacognitive SA completed a series of questionnaires, which assessed their self-reported metacognitive SA, anosodiaphoria, anxiety and depression, apathy, and PTSD symptoms. Results: Low-metacognitive-SA patients showed lower levels of anxiety and depression and higher anosodiaphoria than high-metacognitive-SA patients. Patients with high metacognitive SA and high levels of disability showed significant higher states of anxiety and PTSD symptoms than patients with high metacognitive SA and low levels of disability. Conclusions: The neurorehabilitation of individuals with moderate to severe ABI should address, in particular, the complex interaction between ISA and anxiety and depression in patients during the rehabilitation process. Full article

Diabetes-related pathophysiological processes contribute to endothelial dysfunction, arterial stiffening (AS), hypertension, vascular remodeling, and impaired myocardial perfusion. This study aimed to assess the relationship between arterial wall parameters and sST2 concentration as potential risk factors in type 2 diabetes (T2DM) and investigate sex-related differences. To achieve this, we enrolled 100 patients with suspected or exacerbated coronary artery disease (CAD) and divided them into a T2DM group (n = 58) and a control group (n = 42). Endothelial reactivity (lnRHI), ABI, sST2 levels, and carotid–femoral (cfPWV) and carotid–radial pulse wave velocity (crPWV) were assessed. Coronary angiography was performed in every patient, and epicardial flow and myocardial perfusion were evaluated using QuBE and FLASH. Our results showed that the coronary angiographic findings were similar in both groups. However, T2DM patients had a significantly higher central AS (cfPWV 10.8 ± 2 vs. 9.9 ± 2.7 m/s, p < 0.05) and vascular age (70.0 ± 12.3 vs. 61.3 ± 15.4 years, p < 0.05), while peripheral AS, RHI, and ABI showed no differences. CfPWV correlated with renal function; higher HbA1c and sST2 levels were additionally associated with advanced vascular age. Notably, central AS and vascular age were higher in men with T2DM but not in women. These findings indicate that T2DM patients exhibit increased central AS and vascular aging, influenced by sST2 levels, suggesting fibrosis as a target for precision medicine in T2DM. Full article

Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article

This study builds on Davis’ TAM by integrating environmental and psychological variables relevant to AI medical diagnostics. This study developed a mathematical theoretical model called the “AI medical diagnosis-acceptance evaluation model” (AMD-AEM) to better understand acceptance behavior intention. Using mathematical modeling, we established reflective measurement model indicators and structural equation relationships, where linear structural equations illustrate the interactions among latent variables. In 2025, we collected empirical data from 2380 patients and medical staff who have experience with AI diagnostic systems in teaching hospitals in central Taiwan. Smart PLS 3 was employed to validate the AMD-AEM model. The results reveal that perceived usefulness (PU) and information quality (IQ) are the primary predictors of acceptance behavior intention (ABI). Additionally, perceived ease of use (PE) indirectly influences ABI through PU and attitude toward use (ATU). AI emotional perception (AEP) notably shows a significant positive relationship with ATU, highlighting that warm and positive human–AI interactions are crucial for user acceptance. IQ was identified as a mediating variable, with variance accounted for (VAF) coefficient analysis confirming its complete mediation effect on the path from ATU to ABI. This indicates that information quality enhances user attitudes and directly increases acceptance behavior intention. The AMD-AEM model demonstrates an excellent fit, providing valuable insights for academia and the healthcare industry. Full article

Background/Objectives: Patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) exhibit increased cardiovascular risk, partly attributed to persistent systemic inflammation. Janus kinase inhibitors (JAKi) effectively reduce inflammation, but their impact on cardiovascular risk remains unclear. This pilot study aimed to evaluate the effect of JAKi therapy on systemic inflammation and lipid markers, correlate traditional cardiovascular risk factors with biological parameters, and quantify subclinical atherosclerosis progression. Methods: We conducted a prospective, single-center study including 48 patients receiving JAKi. Clinical, inflammatory, lipid, and vascular parameters were assessed at baseline (T0) and after 12 months (T1). Primary endpoints included changes in carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and carotid plaque presence. Results: Mean cIMT significantly decreased from 0.29 mm to 0.125 mm (p = 0.019), while ABI improved modestly, but not significantly (0.125 to 0.04, p = 0.103). Carotid plaque prevalence increased slightly from 39.6% to 47.9%, p = 0.159. C-reactive protein (CRP) levels declined significantly, while interleukin (IL)-1β levels increased. Lipoprotein(a) [Lp(a)] levels decreased significantly (mean reduction −7.96 mmol/L, p = 0.001). Multivariate regression identified Lp(a) as an independent predictor of carotid plaque at both T0 (p = 0.011) and T1 (p = 0.005). Baseline ABI was a significant predictor of acute cardiovascular events [hazard ratio (HR): 4.614, 95% CI: 1.034–20.596, p = 0.045]. Conclusions: JAKi therapy significantly reduced systemic inflammation and cIMT in patients with autoimmune rheumatic diseases, suggesting a potential benefit in attenuating early vascular changes. However, residual cardiovascular risk remains in patients with low ABI and elevated Lp(a), warranting close monitoring. Full article

Background: Intracranial pressure (ICP) monitoring is crucial in managing acute brain injury (ABI) to prevent secondary brain injury. While invasive techniques remain the gold standard, they can carry notable risks, such as infection and hemorrhage. Non-invasive techniques are increasingly used, but their inter-modality correlation and concordance have not been systematically evaluated. This study aimed to assess the correlation and concordance among four commonly used non-invasive neuromonitoring tools in patients with ABI undergoing invasive ICP monitoring. Methods: This was a secondary analysis of prospectively collected data from 100 adult patients admitted to the intensive care unit with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) who underwent invasive ICP monitoring. Simultaneous assessments using optic nerve sheath diameter (ONSD), transcranial Doppler-derived pulsatility index (PI), estimated ICP (eICP), and the neurological pupil index (NPi) were performed. Correlation between modalities was assessed using Spearman’s correlation coefficient (ρ), and concordance was evaluated with Cohen’s kappa coefficient (k). Results: We found weak correlations between ONSD and PI (ρ = 0.29), ONSD and NPi (ρ = −0.33), and PI and NPi (ρ = −0.33); moderate correlations between ONSD and eICP (ρ = 0.54) and PI and eICP (ρ = 0.48); and a strong inverse correlation between eICP and NPi (ρ = −0.71; all p < 0.05). Concordance was generally low, with the highest agreement between PI and eICP (k = 0.69). Most other tool pairings showed poor-to-fair concordance (k ≤ 0.30). Conclusions: Non-invasive neuromonitoring tools show variable correlation and limited agreement, suggesting they are not interchangeable. Each modality captures different aspects of cerebral physiology, supporting the use of a multimodal approach to improve accuracy in ICP estimation. Full article

Background/Objectives: The ankle-brachial index (ABI) is a non-invasive diagnostic tool for peripheral artery disease (PAD) and a marker of systemic atherosclerosis, predictive of cardiovascular (CV) events. The ambulatory arterial stiffness index (AASI), derived from 24-h blood pressure monitoring, also predicts CV morbidity and mortality, particularly stroke. However, their combined prognostic utility in acute myocardial infarction (AMI) remains underexplored. This study aimed to assess the predictive value of ABI and AASI in patients with AMI. Methods: We conducted a single-center observational cohort study including 441 consecutive patients with AMI (79% male; mean age 62 years). ABI was measured using an automated device, with ≤0.9 defined as abnormal. AASI was calculated from 24-h blood pressure recordings. The primary endpoint was a composite of all-cause and CV death and major CV events, assessed in-hospital and over a 3-year follow-up. Results: Median ABI was 1.10 (IQR 1.00–1.18); 10.4% had abnormal ABI. Abnormal ABI was associated with a threefold higher risk of in-hospital adverse events (OR 2.93, 95% CI: 1.48–5.81, p = 0.002). In Cox regression, abnormal ABI predicted long-term all-cause mortality (HR 2.88, 95% CI: 1.53–5.42, p = 0.001), independent of traditional risk factors. Each 0.1 increase in AASI was linked to a 21% higher risk of the composite outcome (p = 0.001) and 25% increased risk of recurrent AMI or urgent revascularization (p = 0.001). Conclusions: In this prospective cohort of patients with AMI, ABI and AASI were associated with adverse outcomes, suggesting their potential role in risk stratification. These exploratory findings require validation in larger, multicenter cohorts to assess their incremental prognostic value and generalizability. Full article

Background: Falls are a major cause of morbidity and mortality among older adults and are influenced by comorbidities and polypharmacy. Cardiovascular diseases (CVDs) and their associated treatments are particularly prevalent in this population and may contribute to fall risk. Objectives: The objectives of this study were to examine the association between cardiovascular pharmacotherapy and fall risk in older adults and to identify potential preventive strategies. Methods: This observational case–control study was conducted between June and December 2024 and included 200 participants aged over 55 years who provided informed consent. Participants were assessed using the Downton Fall Risk Index and divided into two equal groups, with those at high risk of falling and controls. All participants underwent a comprehensive geriatric assessment, including anamnesis, clinical evaluation, and laboratory testing focused on cardiovascular risk factors. The prevalence of CVD and the use of specific cardiovascular medications were analyzed. Results: Patients at high risk of falling showed significant differences compared to the control group in several parameters, including systolic blood pressure (SBP: 140.41 mmHg vs. 151.28 mmHg, p = 0.001), ankle brachial index (left ABI: 1.09 vs. 1.15., p = 0.033), and presence of cardiovascular diseases (p = 0.001), as well as total cholesterol (p = 0.005) and triglyceride levels (p = 0.047). Certain cardiovascular medications were significantly associated with increased fall risk, including spironolactone (OR = 4.10, p = 0.001), beta-blockers (OR = 1.88, p = 0.031), and calcium channel blockers (OR = 2.05, p = 0.014), especially in combination with one another. Additional risk factors included frailty, cognitive impairment, diabetes, and neurological or osteoarticular conditions. Interventions such as medication review, deprescribing, and dosage adjustments may help reduce fall risk without compromising cardiovascular disease management. Conclusions: Cardiovascular diseases and related pharmacotherapy are significantly associated with an increased risk of falls in older adults. Regular medication reviews, deprescribing where appropriate, and individualized treatment plans may help minimize fall risk while maintaining the effective cardiovascular care of this vulnerable population. Full article

Background and Objectives: This study investigated the frequency and clinical significance of subclinical but substantial peripheral arterial disease (PAD), identified using PAD evaluation, including pulse volume recording/ankle–brachial index (PVR/ABI), transcutaneous oxygen pressure (TcpO2), and skin perfusion pressure (SPP) tests in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Materials and Methods: This study included 54 patients with PAD evaluation results at or after AAV diagnosis. PVR/ABI and/or TcpO2 and/or SPP were performed on the same day. Abnormal PVR/ABI, TcpO2, and SPP were defined as PVR/ABI < 0.97, TcpO2 < 40 mmHg, and SPP < 50 mmHg, respectively. Poor outcomes included all-cause mortality, end-stage kidney disease (ESKD), cerebrovascular accidents, and acute coronary syndrome after PAD evaluation. Results: The median age of the 54 patients was 67 years, and 48.1% were male. In total, 3 of 54 patients (5.6%), 6 of 16 (37.5%), and 6 of 23 (26.1%) had abnormal PVR/ABI, TcpO2, and SPP, respectively. The concordance rate between abnormal PVR/ABI and abnormal TcpO2 or SPP was very low. Among the 54 patients, 5 (9.3%) died, and 2 (3.7%) progressed to ESKD. Abnormal SPP was significantly associated with cutaneous and renal manifestations at the time of PAD evaluation and had the potential to predict progression to ESKD during follow-up in patients with AAV. Conclusions: This study is the first to reveal the clinical usefulness of PAD evaluation: abnormal SPP may have the potential to identify subclinical but substantial PAD and can predict simultaneous kidney involvement as well as future progression to ESKD in patients with AAV. Full article

Background/Objectives: Chronic attention problems occur in approximately 25% of children after acquired brain injury (ABI). When delivered daily, transcranial direct current stimulation (tDCS) may improve attention; however, access to daily in-clinic tDCS treatment can be limited by other commitments, including concurrent therapy, school commitments, and caregiver schedules. Treatment access can be improved through home-based interventions, though these require several practical and safety considerations in a pediatric ABI population. This study evaluated the safety, feasibility, and tolerability of remotely monitored at-home tDCS during online gamified attention training in pediatric ABI. Methods: We conducted a randomized, single-blind, dose-controlled clinical trial of at home tDCS in Brisbane, Australia (10 tDCS sessions; 20 min; 1 mA or 2 mA; bilateral dorsolateral prefrontal cortex). Participants attended our clinic at baseline for clinical assessments, fitting of the personalized tDCS headband, and training in how to use tDCS at home. All sessions were remotely supervised using live videoconferencing. We assessed the feasibility and tolerability of at-home tDCS and our customized, personalized at-home tDCS headband as primary outcomes. As secondary outcomes, we evaluated changes in functional connectivity (fc) and reaction time (RT). Results: Seventy-three participants were contacted over six months (January-June 2023) and ten were enrolled (5 males; mean age: 12.10 y [SD: 2.9]), satisfying a priori recruitment timelines (CONSORT reporting). All families successfully set up tDCS and completed attention training with excellent protocol adherence. There were no serious adverse events over the 100 total sessions. Nine participants completed all stimulation sessions (1 mA: n = 5, 2 mA: n = 4). Participants in the 2 mA group reported greater tingling, itching, and discomfort (all p < 0.05). One participant in the 1 mA group was unable to complete all sessions due to tolerability challenges; however, these challenges were resolved in the second half of the intervention by gradually increasing the stimulation duration across the 10 days alongside additional coaching and support. Conclusions: Overall, daily remotely supervised at-home tDCS in patients with pediatric ABI is safe, feasible, and tolerable. Our results support larger, sham-controlled efficacy trials and provide a foundation for the development of safe and effective at-home stimulation therapeutics that may offer targeted improvement of neurocognitive symptoms in children. Full article

Introduction: Evidence for the diagnostic yield of noninvasive diagnostic assessment for the diagnosis of peripheral arterial disease (PAD) in diabetic foot syndrome (DFS) is poor. Pulse volume recordings (PVRs) at the forefoot level could be a valuable diagnostic tool in the presence of medial arterial calcification. Patients and methods: Patients with DFS who underwent invasive angiography between 01/2020 and 11/2024 and had corresponding PVRs performed within 30 days prior to the procedure were included. DFS was classified according to the Wagner–Armstrong classification. Clinical characteristics and hemodynamic parameters, including systolic ankle pressures and ankle–brachial index were recorded. PVRs were analyzed semiquantitatively by investigators blinded to the clinical information and quantitatively with determination of upstroke time (UST), upstroke ratio (USR), and maximum systolic amplitude (MSA). Angiographic PAD severity was graded according to the GLASS classification. Statistical analysis included univariate significance tests, 2 × 2 contingency tables, receiver–operator characteristic (ROC) analysis and determination of interobserver agreement. Results: In this study, 90 extremities of 70 patients were analyzed, 47 of whom had an ABI ≥ 1.3. Critical limb-threatening ischemia with non-pulsatile PVRs was evident in 6.7%. An abnormal PVR curve morphology (mildly or severely abnormal) yielded a sensitivity and specificity of 63.3% and 85.7% for detection of severe PAD (GLASS stages 2 and 3). Interobserver agreement of semiquantitative PVR rating was substantial (Cohen’s kappa 0.8) in 51 evaluated cases. For detection of any PAD (GLASS ≥ 1) or severe PAD (GLASS ≥ 2), we found the highest diagnostic accuracy for MSA (area under the curve [AUC] 0.89 and 0.82). With a cut-off value of 0.58 mmHg, MSA had a sensitivity of 91.4% and a specificity of 80.8% for detection of any PAD (GLASS ≥ 1). MSA with a cut-off of 0.27 mmHg had a sensitivity of 72.2% and a specificity of 77.1% for detection of severe PAD, whereas the sensitivity and specificity for detection of inframalleolar disease were 62.9% and 69.4%, respectively. Results were consistent in subgroup analyses. Conclusions: PVRs with extraction of quantitative features offer promising diagnostic yield for detection of PAD in the setting of DFS. MSA outperformed UST and USR but showed limited capability of detecting impaired inframalleolar outflow. Full article

Background/Objectives: The benefits of liberal transfusion strategies for neurological outcomes in critically ill patients with acute brain injuries (ABIs) remain uncertain due to conflicting evidence and potential risks. This study aimed to evaluate the efficacy and safety of a liberal transfusion strategy in adults with ABI. Methods: A systematic review of PubMed, Scopus, and the Cochrane Library was conducted from inception until 18 December 2024. Randomized clinical trials (RCTs) comparing liberal and restrictive transfusion strategies in adult patients admitted to intensive care units with ABI were included. The primary outcome was unfavorable neurological function at the last follow-up, defined as Glasgow Outcome Scale (GOS) score <4, Extended GOS score <5, or modified Rankin Scale score >3. Results: Among 5859 screened records, five RCTs (2385 patients) met the inclusion criteria. Liberal transfusion significantly reduced unfavorable neurological outcomes (RR, 0.88; 95% CI, 0.82–0.95; p = 0.0009) without affecting mortality (RR, 0.97; 95% CI, 0.84–1.11; p = 0.66). A meta-analysis of two studies (n = 1465 patients) showed improved functional independence with liberal strategies (MD, 6.70; 95% CI, 2.07–11.33; p = 0.005) but no difference in quality of life (p = 0.30). Sepsis or septic shock occurred less frequently in the liberal group (RR, 0.68; 95% CI, 0.50–0.92; p = 0.01). Subgroup analysis indicated that liberal strategies improved neurological outcome in traumatic brain injury (TBI) patients (RR, 0.89; 95% CI, 0.82–0.97; p = 0.01) but did not yield significant differences in spontaneous subarachnoid hemorrhage (p = 0.09). Conclusions: Liberal transfusion strategies safely improve neurological outcomes in adults with ABI, specifically in the subgroup of TBI, whereas further studies are needed in patients with SAH. Full article

Background: Subclinical atherosclerosis is a “silent” cardiovascular disease that can be devastating when combined with other illnesses. Its presence may affect therapy responses but can potentially worsen hematological malignancies due to most chemotherapy regimens’ cardiovascular adverse effects. Thus, cardiovascular risk factor (CVRF) assessment is required before chemotherapy. Unfortunately, this rarely happens. Aim: we aim to examine the impact of CVRFs on hemodynamic parameters of acute leukemia (AL) patients before chemotherapy. Methods: Overall, 45 AL patients and 26 controls were included. Intima-media thickness (IMT), ankle brachial index (ABI), pulse wave velocity (PWV), and functional cardiac parameters were used. CVRFs were found in 26 AL patients (36.6%), while 19 AL (26.8%) patients lacked CVRFs. CVRFs were also found in 26 controls (36.6%). Results: Left ventricular ejection fraction (LVEF) significantly decreased for patients with CVRFs (59.26 ± 5.62) compared to those without CVRFs (64.05 ± 7.43, p < 0.05). Hypertensive and diabetic patients had a significantly higher left IMT (mm) of 0.92 ± 0.01 compared to those without them (0.76 ± 0.03, p < 0.05). Patients with acute myeloid leukemia (AML) with CVRFs had a significantly higher PWV (m/s) of 8.4 ± 0.12 compared to those without CVRFs (6.87 ± 0.66) (p < 0.05). Conclusions: AL and cardiovascular risk factors interacted before chemotherapy. To decrease cardiotoxicity, AL patients need cardiovascular risk assessment. Subclinical atherosclerosis and echocardiography help chemotherapy patients to choose a treatment regimen, predict long-term outcomes, and predict cardiovascular issues. Full article

Background/Objectives: p-Cresyl sulfate (PCS) is implicated in inflammation, oxidative stress and vascular dysfunction. Hypertension is a major risk factor for peripheral arterial disease (PAD), which is linked to increased mortality in patients with hypertension. This study aimed to evaluate the association between serum PCS levels and PAD in hypertension cases. Methods: We analyzed fasting blood samples and clinical data from 105 patients with hypertension in a cardiovascular outpatient clinic. Serum PCS levels were quantified using high-performance liquid chromatography–mass spectrometry. Ankle–brachial index (ABI) was measured using an automated oscillometric device; ABI < 0.9 indicated PAD. Results: A total of 24 patients (22.9%) had PAD. The PAD group had a higher prevalence of diabetes mellitus (p = 0.026), elevated serum C-reactive protein (CRP) levels (p < 0.001) and increased PCS levels (p = 0.002) than the normal ABI group. Multivariate logistic regression showed that PCS (odds ratio [OR]: 1.154, 95% confidence interval [CI]: 1.013–1.315, p = 0.031) and CRP (per 0.1 mg/dL increase, OR: 1.649, 95% CI: 1.138–2.389, p = 0.008) were independently associated with PAD. According to Spearman’s correlation analysis, log-transformed PCS (log-PCS) levels negatively correlated with left or right ABI (p = 0.001 and p = 0.004, respectively) and estimated glomerular filtration rate (p = 0.001) but positively correlated with log-CRP (p = 0.024). Conclusions: Elevated serum PCS and CRP levels are significantly associated with PAD in patients with hypertension, suggesting the potential role of PCS in PAD pathogenesis. Full article

Background and Objectives: Peripheral arterial disease (PAD) is a severe manifestation of atherosclerosis that disproportionately affects patients with chronic kidney disease (CKD) stages 3–5, resulting in a higher prevalence in this group. Currently, it is challenging to detect early PAD in this patient population. This study investigated the association between serum endocan levels and PAD based on the ankle–brachial index (ABI) in non-dialysis patients with CKD stages 3–5. Materials and Methods: Specimens of blood and baseline demographic characteristics were gathered from a total of 164 patients presenting with stages 3–5 CKD, who were not receiving dialysis. We used a commercially available oscillometric technique to ascertain ABI values for our participants, and used a common and well-established threshold for defining low ABI, known to be associated with PAD: ABI values < 0.9. Endocan levels in patients’ serum samples were measured by using enzyme-linked immunosorbent assays. Results: A total of 24 out of 164 people (14.6%) showed lower-than-normal ABIs. Compared to the group with normal ABIs, the individuals with low ABIs had more of the following conditions: diabetes mellitus (DM, p = 0.030), urine protein-to-creatinine ratio (p = 0.031), serum C-reactive protein concentrations (p = 0.037), and serum endocan levels (p < 0.001). After adjusting for variables significantly correlated with PAD by multivariate logistic regression analysis, age (odds ratio [OR]: 1.097, 95% confidence interval [CI]: 1.038–1.159, p = 0.001), DM (OR: 3.437, 95% CI: 1.053–11.225, p = 0.041), and serum endocan concentration (OR: 1.098, 95% CI: 1.042–1.157, p = 0.001) were identified as independent predictors of PAD in patients with CKD stages 3–5. Conclusions: Elevated serum endocan levels were found to be independent correlates of PAD in non-dialysis patients with CKD stages 3 through 5. Full article