Peripheral arterial disease diagnosed by ankle–brachial index: Predictor for early renal replacement therapy in chronic kidney disease

Özgür, Yasemin; Akın, Seydahmet; Parmaksız, Ergün; Meşe, Meral; Bahçebaşı, Zerrin Bicik; Keskın, Onur

doi:10.4103/1319-2442.279965

Cited by 3 publications

(2 citation statements)

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“…Second, PAD was associated Abnormal ABI was found in half of the chronic hemodialysis patients in this study, with a higher frequency than those reported by Tian (28%), 13 Ašćerić (35%), 14 and Ozgur (44%). 15 Differences in sample size, study population characteristics, and criteria used to define abnormal ABI could explain the difference between their studies of abnormal ABI frequencies. Of note, due to financial constraints, most patients in our study had less than three dialysis sessions per week, resulting in accumulation of some uremic toxins, such as asymmetric dimethylarginine (ADMA), a well-known nitric oxide synthase inhibitor responsible for endothelial dysfunction and subsequent accelerated atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…16 This study found that older age, especially >60 years, was associated with abnormal ABI, which is in agreement with previous reports by Ašćerić 14 and Ozgur. 15 The aging process could lead to accelerated atherosclerosis 17 via vascular remodeling and insulin Ca, calcium; Abnormal ABI (<0.9 or >1.4); normal ABI (0.9-1.3); Vit D, vitamin D.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Significance of Abnormal Ankle–Brachial Index Among Long-term Hemodialysis Patients in Kinshasa, the Democratic Republic of the Congo

Engole

Lepira

Nlandu

et al. 2021

Rambam Maimonides Med J

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Objective: Early identification of atherosclerosis using a non-invasive tool like ankle–brachial index (ABI) could help reduce the risk for cardiovascular disease among long-term hemodialysis patients. The study objective was to assess the frequency and impact of abnormal ABI as a marker of subclinical peripheral artery disease (PAD) in chronic hemodialysis patients. Methods: This was a historic cohort study of kidney failure patients on long-term hemodialysis for at least 6 months. The ABI, measured with two oscillometric blood pressure devices simultaneously, was used to assess subclinical atherosclerosis of low limb extremities. Abnormal ABI was defined as ABI <0.9 or >1.3 (PAD present). Survival was defined as time to death. Independent factors associated with abnormal ABI were assessed using multiple logistic regression analysis. Kaplan–Meier method (log-rank test) was used to compare cumulative survival between the two groups; a P value <0.05 was statistically significant. Results: Abnormal ABI was noted in 50.6% (n=43) of the 85 kidney failure patients included in the study; 42.4% (n=36) had a low ABI, and 8.2% (n=7) had a high ABI. Factors associated with PAD present were cholesterol (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI], 1.01–1.04; P=0.019), inflammation (AOR, 9.44; 95% CI, 2.30–18.77; P=0.002), phosphocalcic product (AOR, 6.25; 95% CI, 1.19–12.87; P=0.031), and cardiac arrhythmias (AOR, 3.78; 95% CI, 1.55–7.81, P=0.009). Cumulative survival was worse among patients with PAD present (log-rank; P=0.032). Conclusion: The presence of PAD was a common finding in the present study, and associated with both traditional and emerging cardiovascular risk factors as well as a worse survival rate than patients without PAD.

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Section: Discussionmentioning

confidence: 99%