title: Exercise-ankle brachial pressure index with one-minute treadmill walking in patients on maintenance hemodialysis.
abstract: BACKGROUND
  The ankle-brachial pressure index (ABI) is widely used as a standard screening method for arterial occlusive lesion above the knee. However, the sensitivity of ABI is low in hemodialysis (HD) patients. Exercise stress (Ex-ABI) may reduce the false negative results.
  
  
  METHODS
  After measuring resting ABI and toe-brachial pressure index (TBI), ankle pressure and ABI immediately after walking (Post-AP, Post-ABI) were measured using one-minute treadmill walking in 52 lower limbs of 26 HD patients. The definition of peripheral arterial occlusive disease (PAD) required an ABI value of less than 0.90, TBI value of less than 0.60, and decrease of more than 15% of the Post-ABI value and 20 mmHg of Post-AP in Ex-ABI. Computed tomographic angiography (CTA) was performed in 32 lower limbs of 16 HD patients. PAD is defined as presence of stenosis of more than 75% in the case of lesions from an iliac artery to knee on CTA.
  
  
  RESULTS
  The accuracy of Ex-ABI (Sensitivity, 85.7%; Specificity, 77.7%) was higher than those of ABI (Sensitivity, 42.9%; Specificity, 83.3%) or TBI (Sensitivity, 78.6%; Specificity, 61.1%).
  
  
  CONCLUSIONS
  Ex-ABI with one-minute treadmill walking is the most useful tool for the screening of arterial occlusive lesions above the knee in maintenance HD patients.
authors: Odawara Cardiovascular Hospital, Odawara, Kanagawa, Japan ; Development Center to Support Health and Welfare, Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan.
authors: Kazuo
authors: K
authors: Tsuyuki
authors: Kenji
authors: K
authors: Kohno
authors: Kunio
authors: K
authors: Ebine
authors: Takehiro
authors: T
authors: Obara
authors: Toshiyuki
authors: T
authors: Aoki
authors: Atsuhiko
authors: A
authors: Muto
authors: Kenji
authors: K
authors: Ninomiya
authors: Kenta
authors: K
authors: Kumagai
authors: Itaru
authors: I
authors: Yokouchi
authors: Yoshiyuki
authors: Y
authors: Yazaki
authors: Shinichi
authors: S
authors: Watanabe
keywords: diagnosis; exercise; hemodialysis; peripheral arterial disease; screening
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