2021 Volume 54 Issue 3 Pages 123-129
We measured skin perfusion pressure (SPP) as a screening test for lower limb peripheral arterial disease (PAD) in 90 hemodialysis patients. The accuracy of the test was compared based on the measurement timepoint and measurement site. Measurements were obtained from the dorsal and plantar surfaces of the foot, before dialysis and during the latter half of dialysis (20 minutes before the end of dialysis). The SPP values at each site decreased significantly during the latter half of dialysis. In addition, the SPP values were higher on the plantar surface of the foot than on the dorsal surface of the foot. When the SPP cut‒off value was set at 50 mmHg, the detection rate of PAD on the dorsal surface of the foot was 67.3％ before dialysis and 77.6％ during the latter half of dialysis, while the detection rate of PAD on the plantar surface of the foot was 32.7％ before dialysis and 55.1％ during the latter half of dialysis. In comparisons of test accuracy according to the measurement time points using the timepoint based on receiver operating characteristic (ROC) analysis, the optimal cut‒off value was found to be 64 mmHg before dialysis and 54 mmHg during the latter half of dialysis, regardless of the measurement site. In PAD screening based on SPP during dialysis, it is important to set a cut‒off value that is appropriate for the measurement timepoint.
