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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

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Published on: June 16, 2014

Decrease in ankle-brachial index over time and cardiovascular outcomes in patients with hemodialysis.

Szu-Chia Chen1, Jer-Ming Chang, Wan-Chun Liu

  • 1Divisions of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

The American Journal of the Medical Sciences
|November 30, 2012
PubMed
Summary
This summary is machine-generated.

A significant decrease in ankle-brachial index (ABI) over time predicts cardiovascular events in hemodialysis patients. This finding highlights ABI changes as a valuable prognostic indicator for this high-risk population.

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Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Medicine

Background:

  • Abnormal ankle-brachial index (ABI) is linked to higher morbidity and mortality in hemodialysis (HD) patients.
  • The prognostic significance of ABI decline over time in HD patients remains unclear.

Purpose of the Study:

  • To determine if a decrease in ABI over time predicts cardiovascular (CV) prognosis in HD patients.

Main Methods:

  • 234 HD patients were enrolled; 173 completed follow-up.
  • ABI was measured at baseline and 1-year follow-up. ΔABI = 1-year ABI - baseline ABI.
  • Progressors (ΔABI < -0.3) were identified; CV events included CV death, MI, stroke, and heart failure hospitalizations.

Main Results:

  • Follow-up averaged 37.8 months.
  • ABI progressors (ΔABI < -0.3) showed a 2.71-fold increased risk of CV events (P=0.03).
  • Decreased albumin and increased hs-CRP also predicted CV events.

Conclusions:

  • A significant decrease in ABI (ΔABI < -0.3) is an independent predictor of increased CV events in HD patients.
  • Monitoring ABI changes over time may identify HD patients at high risk for adverse CV outcomes.