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Low ankle-brachial index associated with rise in creatinine level over time: results from the atherosclerosis risk in

Ann M O'Hare1, Rudolph A Rodriguez, Peter Bacchetti

  • 1Department of Medicine, University of California, San Francisco, USA. Ann.O'Hare@med.va.gov

Archives of Internal Medicine
|July 13, 2005
PubMed

Insights

A low ankle-brachial index (ABI) predicts cardiovascular events. This study shows a low ABI also predicts a decline in kidney function over time, indicating broader health risks.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Epidemiology

Background:

  • A low ankle-brachial index (ABI) is a known predictor of cardiovascular mortality, myocardial infarction, peripheral arterial disease events, and stroke.
  • The association between a low ABI and the decline of renal function has not been previously established.

Purpose of the Study:

  • To investigate the association between ankle-brachial index (ABI) and the change in serum creatinine levels over time.
  • To determine if a low ABI predicts a decline in renal function.

Main Methods:

  • The Atherosclerosis Risk in Communities (ARIC) study cohort of 13,655 participants was analyzed.
  • Serum creatinine and ABI were measured at baseline, with serum creatinine re-measured 3 years later.
  • The primary outcome was a 50% or greater increase in serum creatinine level from baseline to the second visit.

Main Results:

  • A 50% or greater increase in serum creatinine occurred in 0.48% of participants with ABI ≥ 1, 0.9% with ABI 0.9-0.99, and 2.16% with ABI < 0.9.
  • Participants with an ABI < 0.9 had more than double the odds of experiencing a serum creatinine increase (OR 2.5; 95% CI, 1.1-5.7; P = .04).
  • A significant linear trend of worsening renal function was observed across ABI categories (P = .02).

Conclusions:

  • A low ankle-brachial index (ABI) is a predictor of future decline in renal function.
  • The findings extend the known prognostic value of ABI beyond cardiovascular and cerebrovascular events to include renal function.
  • ABI measurement may help identify individuals at risk for worsening kidney function.
Abstract

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