Authors: Shigeru Otsubo Mariko Kitamura Takako Wakaume Aiji Yajima Miwa Ishihara Masayo Takasaki Syuitsu Ueda Hisayuki Sugimoto Kimiko Otsubo Naoki Kimata Takashi Akiba Kosaku Nitta
Publish Date: 2010/12/14
Volume: 44, Issue: 2, Pages: 569-573
Abstract
Peripheral artery disease PAD is a common complication in hemodialysis patients The anklebrachial blood pressure index ABI has been widely used to screen for subclinical PAD In the present study we investigated the association between ABI and longterm up to 88 years mortality among hemodialysis patientsA total of 86 consecutive patients receiving maintenance hemodialysis who underwent an ABI examination between 2001 and 2003 were retrospectively enrolled in this study Patients with an ABI of less than 09 were considered as having PAD those with an ABI of more than 09 in both legs were considered as being free from PAD We examined the relationship between mortality and several risk factorsDuring the followup period 43 deaths were recorded In the univariate regression analysis the mortality hazard ratio HR of patients with PAD was 167 95 confidence interval CI 118–228 Other predictive variables for mortality included male gender age and diabetes mellitus P = 0006 P = 0024 and P = 0023 respectively A multivariate Cox analysis identified PAD and male gender as independent predictors of mortality P = 0033 and P = 0028 respectively The impact of age and diabetes mellitus on mortality was no longer significant in the multivariate analysisAfter a relatively longterm observation period a multivariate analysis indicated that PAD acted independently of other risk factors including advanced age and the presence of diabetes mellitus ABI measurements can be used to identify highrisk hemodialysis patients requiring intensive followup care
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