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Published on: June 2, 2022
Radial augmentation index may be an effective predictor of vascular calcification in patients on peritoneal dialysis
Ning Yang1, Wei Yang1, Wenting Cui1
1Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Insights
Radial augmentation index (RAI) is a potential predictor of vascular calcification (VC) and cardiac issues in patients on peritoneal dialysis (PD). Higher RAI levels correlate with more severe VC and adverse cardiac structural and functional changes in PD patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biomedical Engineering
Background:
- Vascular calcification (VC) significantly increases cardiovascular disease (CVD) risk in peritoneal dialysis (PD) patients.
- Existing VC assessment tools like AACI and IMT can be complex or costly.
- Simpler, cost-effective predictors for VC in PD patients warrant investigation.
Purpose of the Study:
- To evaluate the radial augmentation index (RAI) as a potential predictor of vascular calcification (VC).
- To assess the correlation between RAI and cardiac structural/functional abnormalities in PD patients.
- To compare RAI in PD patients with healthy controls (HCs).
Main Methods:
- 101 PD patients and 50 HCs were recruited.
- Measurements included RAI, abdominal aortic calcification index (AACI), carotid artery intima-media thickness (IMT), and echocardiography.
- Statistical analyses, including correlation and multiple linear regression, were performed.
Main Results:
- RAI was significantly higher in PD patients than HCs (86.25%±8.39% vs. 76.05%±9.81%, p<0.05).
- RAI positively correlated with AACI (r=0.671) and IMT (r=0.596) in PD patients.
- RAI showed significant correlations with left ventricular dimensions, mass index, diastolic function, and ejection fraction.
Conclusions:
- RAI may serve as an effective and accessible predictor for VC in PD patients.
- RAI is associated with cardiac structural and functional changes, highlighting its clinical utility.
- Further research should explore RAI's role in managing CVD risk in PD populations.
Abstract:
Vascular calcification (VC) is an important promoter of cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD). Several indices can be used to evaluate VC, including the abdominal aortic calcification index (AACI) and carotid artery intima-media thickness (IMT); however, simpler and lesser expensive predictors, such as the radial augmentation index (RAI), should be investigated. A total of 101 patients undergoing PD were recruited to measure RAI, AACI, and carotid artery IMT and perform echocardiography. Fifty healthy controls (HCs) were recruited to undergo RAI measurement. RAI in patients undergoing PD was significantly higher than the RAI in HCs (86.25%±8.39% vs. 76.05%±9.81%, p < 0.05). Patients undergoing PD and who suffer with diabetic mellitus, hypertension, and CVD had more severe VC than those without the abovementioned diseases. In patients with PD, RAI was positively correlated with AACI (r = 0.671, p < 0.05) and carotid artery IMT (r = 0.596, p < 0.05). RAI was positively correlated with left ventricular end-diastolic dimensions (LVDd; r = 0.678, p < 0.05), left ventricular mass index (r = 0.595, p < 0.05), and negatively correlated with early-diastolic mitral inflow velocity/late-diastolic mitral inflow velocity (r = -0.342, p < 0.05) and left ventricular ejection fraction (r= -0.497, p < 0.05). Multiple linear regression analysis showed that RAI was associated with AACI, LVDd, age, and serum phosphate (p < 0.05). RAI might be an effective predictor of VC and cardiac structural/functional abnormalities in patients undergoing PD.
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Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:

