[Evaluation of the severity of vascular impairment in the lower extremities in patients with chronic kidney failure].
BACKGROUND
Arterial ischemic disease represents highly serious complication for patients undergoing chronic haemodialysis. The aim of the study was to examine peripheral arteries in the group of haemodialysed patients and to estimate the incidence and seriousness of pathological findings.


RESULTS
Total 82 sonographic examinations of arteries in lower extremities using Multi Dopplex II set with graphic registration of dopplex curves was done in 53 dialysed patients. Blood pressure values of four peripheral arteries at legs together with blood pressure values at the brachial artery were evaluated as the ankle-arm index (API). Character of changes of dopplex curves was classified as SO index (obliteration index). Also with normal API, changes in SO were identified. SO index was significantly higher (p = 0.034) in patients of the peritoneal dialysis program in comparison with haemodialysed patients, in persons with diabetes the value was only marginally higher. Patients who died later (of the cardiovascular complications), the SO index was significantly higher then in others (p < 0.0001), though the API values were not different. Repeated testing in 29 patients after 6 months brought about worsening of the SO index (p < 0.00001) in those patients where no changes of API were seen. No relation with any of the followed biochemical parameters was found.


CONCLUSIONS
To estimate most accurately the conditions of the peripheral arteries in dialysed patients ankle-arm index was used together with evaluation of the shape of dopplex curves (index SO). Such detailed Doppler examination has proved identifiable changes of arteries in 73 out of 82 cases.
Saková
R
R
Interní oddĕlení Strahov 1. LF UK a VFN, Praha. jherm@lf1.cuni.cz
Sulková
S
S
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018616:Ultrasonography, Doppler, Duplex