Format

Send to:

Choose Destination
See comment in PubMed Commons below
Nephron Clin Pract. 2010;114(1):c29-37. doi: 10.1159/000245067. Epub 2009 Oct 9.

A small reduction in the ankle-brachial index is associated with increased mortality in patients on chronic hemodialysis.

Author information

  • 1Division of Blood Purification, Hamamatsu University School of Medicine, Shizuoka, Japan. a.kato@hama-med.ac.jp

Abstract

BACKGROUND:

High pulse wave velocity (PWV) and a low ankle-brachial index (ABI) are associated with mortality in hemodialysis (HD) patients. Recently, the cardio-ankle vascular index (CAVI) was developed as a novel index of arterial stiffness independent of blood pressure.

METHODS:

We compared brachial-ankle PWV (baPWV), the ABI and the CAVI as predictors of mortality in 194 HD patients (age 64 +/- 12 years; time on HD 111 +/- 96 months) during a follow-up period of 39 +/- 4 months (range 31-46).

RESULTS:

The ABI was significantly positively correlated with serum albumin and negatively with log-transformed highly sensitive C-reactive protein (p < 0.01), while baPWV and the CAVI were not. Of 194 patients, 39 patients (20.1%) died during the follow-up, 25 (64.1%) of cardiovascular causes. Kaplan-Meier analysis revealed that the patients with an ABI in the lowest tertile (<1.0) had a significantly lower survival rate (p < 0.01). Cox hazards analysis after adjustment for the conventional risk factors revealed that an ABI value in the lowest tertile was a determinant of total mortality when compared with ABI values in the highest tertile [>1.1; hazard ratio 3.50 (95% confidence interval 1.20-10.20); p = 0.02]. In contrast, baPWV and the CAVI were not associated with mortality.

CONCLUSION:

These findings suggest that a small reduction in the ABI (<1.0) is an independent predictor of all-cause mortality in chronic HD patients.

Copyright 2009 S. Karger AG, Basel.

PMID:
19816041
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for S. Karger AG, Basel, Switzerland
    Loading ...
    Write to the Help Desk