Increasing prevalence of peripheral artery occlusive disease in hemodialysis patients:  a 2-year follow-up.
BACKGROUND
Peripheral artery occlusive disease (PAOD) has been reported to be prevalent in hemodialysis patients and influence their mortality. Ankle-brachial index (ABI) <0.9 is a reliable marker for PAOD. The aims of the 2-year longitudinal study were to assess whether there was a progression in PAOD and to find out the determinants of ABI progression in hemodialysis patients.


METHODS
This study enrolled 237 routine hemodialysis patients and 154 patients completed the 2-year follow-up. The ABI was measured by an ABI-form device at baseline and at the first and second year follow-up. The change in ABI (ΔABI) was defined as ABI measured at the second year follow-up minus ABI measured at baseline.


RESULTS
The prevalence of ABI <0.9 increased yearly (10.4%, 22.7% and 27.9%, respectively; P < 0.001) and the values of ABI decreased yearly (1.11 ± 0.16, 0.97 ± 0.17 and 0.96 ± 0.19, respectively; P < 0.001) in the 154 follow-up patients. Multiple stepwise analysis identified fasting glucose level, calcium-phosphorous product, high-sensitivity C-reactive protein and homocysteine level as independent determinants of ΔABI.


CONCLUSIONS
Our results demonstrated the prevalence of PAOD increased and the values of ABI decreased yearly in hemodialysis patients. The ABI progression was associated with high fasting glucose level, high calcium-phosphorous product, high-sensitivity C-reactive protein and low homocysteine levels.
Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Szu-Chia
SC
Chen
Ho-Ming
HM
Su
Jer-Ming
JM
Chang
Wan-Chun
WC
Liu
Jer-Chia
JC
Tsai
Yi-Chun
YC
Tsai
Ming-Yen
MY
Lin
Shang-Jyh
SJ
Hwang
Hung-Chun
HC
Chen
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000639:trends