A reconciling criterion for early detection of asymptomatic PAD in HD patients

Paik Seong Lim,Yachung Jeng

doi:10.1080/2331205x.2018.1469595

Abstract

Peripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is common in hemodialysis (HD) patients, while usually underdiagnosed because most patients were asympto...

Highlights

Peripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is highly prevalent in hemodialysis (HD) patients (Jabbari et al, 2012; Lim et al, 2005)
By exploring the patterns of the PAD incidence and medical conditions among three groups of hemodialysis patients: intermediate group (ABI 0.9–1), abnormal group (ABI ≤0.9), and upper group (ABI >1), we found that the intermediate group had patterns significantly different from the upper group and non-significantly different from the abnormal group
Our findings imply that intensive surveillance and advanced diagnostic workup or medical care regarding prevention on atherosclerosis progress should be considered for hemodialysis patients with ankle-brachial index (ABI) values within the lower normal range (0.90–1)

Summary

Introduction

Peripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is highly prevalent in hemodialysis (HD) patients (Jabbari et al, 2012; Lim et al, 2005). PAD is usually underdiagnosed and undertreated or even delayed for treatment, since most patients were asymptomatic. We are well aware that adverse outcomes such as cardiovascular diseases (Kuwahara et al, 2014; Liu et al, 2010) and vascular access failure (Chen et al, 2009; Singh, Anderson, Pillai, & Kalva, 2015) are correlated to PAD. An ankle-brachial index (ABI) of 0.9 or less is the currently accepted criterion for clinical diagnosis of PAD (Chen et al, 2010; Garimella et al, 2012; Tendera et al, 2011). With an idea of empirically validating, we retrospectively analyzed a cohort of HD patients to assess if using any lenient criterion of ABI could help predicting future risk of asymptomatic PAD in HD patients

Methods

Results

Conclusion