Document Detail

Rate of ankle-brachial index decline predicts cardiovascular mortality in hemodialysis patients.
MedLine Citation:
PMID:  24499079     Owner:  NLM     Status:  In-Data-Review    
Chronic kidney disease is a risk factor for cardiovascular mortality and morbidity of cardiovascular events (CVEs). We obtained baseline data regarding blood biochemistry, ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV) and echocardiographic parameters from 300 patients on hemodialysis in 2005. We also measured ABI and baPWV annually from June 2005 until June 2012 and calculated rates of changes in ABI and baPWV to identify factors associated with CVEs. Seventy-three patients died of cardiovascular disease and 199 CVEs occurred in 164 patients during the study period. Cardiac, cerebrovascular and peripheral artery disease (PAD) events occurred in 124, 43 and 32 patients, respectively, and 30 patients had more than two types of CVEs. Analysis using the Cox proportional hazards model showed that a higher rate of decline in ABI (hazard ratio [HR], 4.034; P < 0.001) was the most significant risk factor for decreased patient survival. Multivariate Cox analysis revealed that a higher rate of ABI decline (HR, 2.342; P < 0.001) was a significant risk factor for cardiac events, and that a lower baseline ABI was a risk factor for cerebrovascular (HR, 0.793; P = 0.03) and PAD (HR, 0.595; P < 0.0001) events. Our findings suggested that the rate of a decline in ABI and the baseline ABI value are potent correlation factors for survival and CVE morbidity among patients on hemodialysis in Japan.
Michio Kuwahara; Syoko Hasumi; Shintaro Mandai; Tomomi Tanaka; Satomi Shikuma; Wataru Akita; Yoshihiro Mori; Sei Sasaki
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Publication Detail:
Type:  Journal Article     Date:  2013-07-03
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  18     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-02-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  9-18     Citation Subset:  IM    
Copyright Information:
© 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.
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