Ankle‐Brachial Index and Long‐Term (10 Years) Survival of Nondiabetic Hemodialysis Patients

Abstract

Low (<0.9) and high (>1.4) ankle brachial index (ABI) is associated with a higher cardiovascular (CV) mortality in the general and hemodialysis (HD) population. The aim of our study was to determine the impact of ABI on long-term survival of 52 non-diabetic HD patients. The ABI was determined using an automated, non-invasive waveform analysis device. Patients were divided into three groups: low (<0.9), normal (0.9-1.4) and high (>1.4) ABI. Patients were observed from the date of ABI measurement until their death or ten years. Survival analysis showed higher risk for CV death in HD patients with high ABI compared to normal ABI (log rank test P < 0.027). In Cox regression model adjusted for arterial hypertension, smoking, serum cholesterol and triglycerides, high ABI (P < 0.049) remained a predictor of mortality. The results indicate an association between ABI and long-term survival of non-diabetic HD patients and only high ABI was associated with higher CV mortality.

High ankle-brachial index predicts cardiovascular events and mortality in hemodialysis patients with severe secondary hyperparathyroidism

“…In our study, the majority of the patients presented vascular stiffness according to ABI, probably due to the severity of SHPT and high prevalence of hyperphosphatemia. Despite several studies in which an ABI>1.3 demonstrated a higher occurrence of cardiovascular events, in patients either on dialysis 10,[12][13][14] or not [28][29][30][31][32] , we did not find studies in patients with severe SHPT. London et al 33 demonstrated that low bone turnover was related to peripheral arterial disease (PAD) and it was inversely related to parathyroidectomy (PTX).…”

“…Obstructive arterial disease can be identified by low ABI (<0.9), and high ABI (>1.3) has been associated with vascular calcification due to arterial incompressibility 10,11 . In dialysis patients, low and high ABI were related to cardiovascular events and mortality 10,[12][13][14] .…”

Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients

“…Thus, ABI measurement alone does not reliably identify patients with media calcification. Previously, both a low and high ABI were found to be independently associated with all-cause and cardiovascular mortality in hemodialysis patients (7,9,29). A low ABI has also been shown to predict mortality in PD patients (1,30).…”

Diabetic patients with chronic kidney disease: Non-invasive assessment of cardiovascular risk

“…Similar association was found between renal function, cardiovascular events and high ABI[ 94 ]. In a study on 52 hemodialysis patients by Bevc et al [ 95 ], survival analysis showed higher risk for cardiovascular death in patients with ABI > 1.4. It appears that the systemic nature of atherosclerosis is only partly responsible for these effects of changed ABI and that increased arterial stiffness and consequent hemodynamic changes play an integral role as well[ 96 ].…”