Atherosclerotic risk factors among ankle-brachial index and toe-brachial index in peritoneal dialysis patients.
BACKGROUND
Atherosclerotic vascular change affecting the lower extremities is the most common peripheral vascular disease. Ankle-brachial index (ABI) and toe-brachial index (TBI) are common, non-invasive diagnostic tests for atherosclerosis in the lower extremities. Peritoneum is a vascular-based structure. The use of glucose-based hyperosmolar solutions for PD patients results in a significant increase in blood glucose load and can be considered atherogenic. The association between ABI or TBI values and peritoneal function in patients undergoing peritoneal dialysis remains unclear. We presumed that the risk factors for atherosclerosis in large and small vessels may differ.


METHODS
A total of 146 peritoneal dialysis patients, 41 males and 105 females (119 without diabetes and 27 with diabetes), received peritoneal dialysis for more than four months. Patients who had dialysis-related peritonitis within six months prior to this study were excluded. The ABI or TBI was determined using an automated, non-invasive, waveform analysis device.


RESULTS
The ABI value correlated positively with mean arterial pressure and TBI value. The TBI value correlated positively with ABI value and inversely with fasting serum glucose and serum total cholesterol concentrations. Peritoneal function was not correlated with ABI or TBI.


CONCLUSIONS
This cross-sectional study demonstrated that risk factors in peritoneal dialysis patients for atherosclerosis in large vessels and small vessels differed. Interestingly, peritoneal function test is not associated with ABI or TBI value. However, further investigation of the association between ABI or TBI value and cardiovascular events is required for this patient group.
Huang
Wen-Hung
WH
Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan, R.O.C.
Chen
Yung-Chang
YC
Hung
Cheng-Chieh
CC
Huang
Jeng-Yi
JY
Lin
Ja-Liang
JL
Yang
Chih-Wei
CW
D000328:Adult; D000842:Ankle / Q000098:blood supply*; D050197:Atherosclerosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D001916:Brachial Artery / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D014034:Toes / Q000098:blood supply*