2020 Volume 53 Issue 2 Pages 53-59
[Purpose] The digital brachial pressure index (DBI) has become an established tool for diagnosing dialysis access steel syndrome (DASS), but it has not been adopted in Japan. There have also been many reports about the use of skin perfusion pressure (SPP) to diagnose DASS. In this study, we compared the utility of the DBI and SPP as tools for diagnosing DASS. [Methods] The subjects were 119 patients with AV shunts. They were classified based on the presence/absence of DASS, and the diagnostic ability of each parameter was compared via ROC analysis. Moreover, DASS was classified into mild and severe cases, and the ability of each parameter to discriminate between such cases was compared via ROC analysis. [Results] This study involved 51 patients (108 fingers) without DASS and 68 patients (130 fingers) with DASS. The DBI and SPP cut-off values used to diagnose DASS were 0.67 and 61 mmHg, respectively, and those used for distinguishing between mild and severe cases were 0.51 and 30 mmHg, respectively. SPP was significantly superior to DBI for diagnosing DASS and determining its severity. [Conclusions] It was suggested that SPP is superior to DBI as a tool for diagnosing DASS.
