Abstract
To evaluate the AABI as a marker of arteriosclerotic disease in hemodialysis (HD) patients, we measured AABI in 101 patients on HD once a month for about 1 year. The AABI was compared in patients with or without coronary artery disease (CAD), cerebrovascular disease (CVD) and peripheral vascular disease (PVD). The AABI was significantly lower in patients with disease than in those without disease (CAD: 0.99±0.16 vs 1.17±0.10; CVD: 1.02±0.18 vs 1.13±0.13; PVD: 0.95±0.15 vs 1.13±0.13). The mean AABI decreased as the number of vascular diseases decreased (0: 1.18±0.09; 1: 1.09±0.13; 2: 0.91±0.14). In patients with or without DM, the mean AABI was respectively 0.98±0.16 and 1.16±0.11. For HT, it was 1.08±0.17 and 1.15±0.10. In all patients, the absolute magnitude of the AABI correlated with age, but not with the duration of HD. The correlation between the AABI and age was seen in non-DM patients, but not in DM patients. These data suggest that, in DM patients, arteriosclerotic disease was strongly influenced by factors other than age, namely the degree of the diabetic complications. Of the patients with vascular disease 31.3% showed an AABI value above 1.0, of whom 88.0% had calcification of the arteries of the lower extremities, and if the patients with calcification were excluded, only 3.8% had sclerotic diseases. One should be aware of this phenomenon, when evaluating the AABI. In patients with an AABI of less than 1.0, 95.2% had overt vascular disease. We concluded that the AABI serves as a powerful marker for the presence and intensity of systemic arteriosclerotic vascular disease of HD patients.
