title: Risk factors of normal ankle-brachial index and low toe-brachial index in hemodialysis patients.
abstract: The prevalence of peripheral arterial occlusive disease is high in patients with terminal renal failure, and it is a major problem in those on dialysis. A low ankle-brachial index (ABI) suggests the presence of arterial stenotic lesions between the aorta and the ankle joint, while a low toe-brachial index (TBI) suggests stenotic lesions between the aorta and the toes. Therefore, a normal ABI (> or =0.9) and a low TBI (<0.6) may indicate the presence of stenotic lesions located only on the peripheral side of the ankle joint. In the present study, risk factors of normal ABI/low TBI were investigated. In 115 patients on maintenance dialysis, the ABI and TBI were simultaneously measured, and the background factors and laboratory data of patients with normal ABI/low TBI (L group) and those with normal ABI/normal TBI (> or =0.6) (N group) were compared. Low ankle-brachial and toe-brachial indices were detected in 13% and 22% of the patients, respectively. Comparison of the background factors and laboratory data between the N and L groups showed that the ratio of diabetes mellitus, interdialytic body weight gain, and Hb(A1c) values were significantly higher in the L group than in the N group. It was clarified that diabetes and excess body weight gain are involved as risk factors in dialysis patients with normal ABI/low TBI.
authors.affiliation: Second Department of Internal Medicine, Kansai Medical University, Hirakata, Japan. morimots@hirakata.kmu.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morimoto
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nakajima
authors.forename: Takatomi
authors.initials: T
authors.lastname: Yurugi
authors.forename: Tatsuyori
authors.initials: T
authors.lastname: Morita
authors.forename: Fusakazu
authors.initials: F
authors.lastname: Jo
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
authors.forename: Kei
authors.initials: K
authors.lastname: Maki
mesh_terms: D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000209:etiology; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000209:etiology; D006435:Renal Dialysis; D012307:Risk Factors; D015430:Weight Gain