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Association of peripheral artery disease and long-term mortality in hemodialysis patients

International Urology and Nephrology volume 44, pages 569–573 (2012)Cite this article

Abstract

Background

Peripheral artery disease (PAD) is a common complication in hemodialysis patients. The ankle-brachial blood pressure index (ABI) has been widely used to screen for subclinical PAD. In the present study, we investigated the association between ABI and long-term (up to 8.8 years) mortality among hemodialysis patients.

Methods

A total of 86 consecutive patients receiving maintenance hemodialysis who underwent an ABI examination between 2001 and 2003 were retrospectively enrolled in this study. Patients with an ABI of less than 0.9 were considered as having PAD; those with an ABI of more than 0.9 in both legs were considered as being free from PAD. We examined the relationship between mortality and several risk factors.

Results

During the follow-up period, 43 deaths were recorded. In the univariate regression analysis, the mortality hazard ratio (HR) of patients with PAD was 1.67 (95% confidence interval [CI], 1.18–2.28). Other predictive variables for mortality included male gender, age, and diabetes mellitus (P = 0.006, P = 0.024, and P = 0.023, respectively). A multivariate Cox analysis identified PAD and male gender as independent predictors of mortality (P = 0.033 and P = 0.028, respectively). The impact of age and diabetes mellitus on mortality was no longer significant in the multivariate analysis.

Conclusion

After a relatively long-term observation period, a multivariate analysis indicated that PAD acted independently of other risk factors, including advanced age and the presence of diabetes mellitus. ABI measurements can be used to identify high-risk hemodialysis patients requiring intensive follow-up care.

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Affiliations

  1. Sangenjaya Hospital, 1-21-5 Sangenjaya, Setagaya-ku, Tokyo, 154-0024, Japan

    Shigeru Otsubo, Mariko Kitamura, Takako Wakaume, Miwa Ishihara, Masayo Takasaki, Syuitsu Ueda, Hisayuki Sugimoto & Kimiko Otsubo

  2. Faculty of Human Care, Department of Nursing, Tohto College of Health Sciences, Saitama, Japan

    Shigeru Otsubo

  3. Towa Hospital, Tokyo, Japan

    Aiji Yajima

  4. Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan

    Naoki Kimata & Takashi Akiba

  5. Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan

    Kosaku Nitta

Authors
  1. Shigeru Otsubo
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  2. Mariko Kitamura
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  3. Takako Wakaume
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  4. Aiji Yajima
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  5. Miwa Ishihara
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  7. Syuitsu Ueda
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  8. Hisayuki Sugimoto
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  9. Kimiko Otsubo
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  11. Takashi Akiba
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  12. Kosaku Nitta
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Correspondence to Shigeru Otsubo.

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Otsubo, S., Kitamura, M., Wakaume, T. et al. Association of peripheral artery disease and long-term mortality in hemodialysis patients. Int Urol Nephrol 44, 569–573 (2012). https://doi.org/10.1007/s11255-010-9883-8

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  • DOI: https://doi.org/10.1007/s11255-010-9883-8

Keywords

  • Ankle-brachial index
  • Chronic kidney disease
  • Long-term outcome
  • Peripheral artery disease