Korean J Nephrol.  2003 Nov;22(6):722-730.

ABI and Risk Factors of Peripheral Vascular Disease in Maintenance Dialysis Patients: According to the Modality of Dialysis

• Lee YS
• Oh HJ
• Kang DH
• Yoon KI
• Choi KB

Abstract

BACKGROUND
PVD is a risk marker for coronary disease, cerebrovascular disease and many other conditions. One of the simplest, noninvasive and most useful parameters to objectively assess PVD is the ankle-brachial index (ABI). The aim of our study was to explore the frequency, severity and the risk factors of peripheral vascular disease in dialysis patients, especially according to dialysis modality. METHODS: We studied 85 maintenance dialysis patients (HD 50 patients, PD 35 patients) and control (n=73) who has normal serum creatinine without DM, hypertension. ABI was tested during about 2 hrs into the hemodialysis by doppler ultrasono (Smartdop 30, HADECO, Japan). The severity of PVD was stratified into 3 groups based upon ABI [normal (0.9< or =ABI<1.5), moderate (0.5< or =ABI<0.9), severe (ABI< 0.5)]. RESULTS: ABI was significantly lower in the dialysis patients than control (0.85+/-0.23 vs 1.13+/-0.25, p<0.001). HD patients had lower ABI (0.80+/-0.24 vs 0.94+/-0.18, p<0.01) and lower BMI (corrected by PD dialysate weight; 21.9+/-3.6 vs 24.0+/-3.3, p<0.05) compared with PD patients. DM pts (%), hypertension pts (%), age, duration of dialysis and smoking amount were not different between HD and PD pts. The patients number of major PVD was significantly higher in HD than PD (14% vs 0%, p<0.001). Univariate regression analysis in dialysis pts demonstrated that old age (> or =55 yrs), duration of dialysis and HD were negatively correlated with ABI: r= -0.309; p<0.01 for HD modality. Multiple regression analysis demonstrated that HD modality (than PD) predicted ABI with an adjusted R2=0.206 and p<0.01. CONCLUSION: We conclude that ABI was significantly decreased in HD pts than PD pts. The frequency of severe PVD was significantly higher in HD pts than PD pts. These findings suggest that dialysis modality may be related to the severity of PVD in the maintenance dialysis patients. Further studies are needed to understand the association between PVD and nutrition factors, inflammation markers and dialysis- or uremia-related factors in maintenance dialysis patients.

Keyword

Ankle-Brachial index; Dialysis modality; Peripheral vascular disease (PVD)

MeSH Terms

Ankle Brachial Index
Coronary Disease
Creatinine
Dialysis*
Humans
Hypertension
Inflammation
Peripheral Vascular Diseases*
Renal Dialysis
Risk Factors*
Smoke
Smoking
Creatinine
Smoke