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

Peripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is common in hemodialysis (HD) patients, while usually underdiagnosed because most patients were asymptomatic. Some evidence indicated that the currently accepted criteria of ankle-brachial index (ABI) for c...

Full description

Bibliographic Details
Main Authors: Paik Seong Lim, Yachung Jeng
Format: Article
Language:English
Published: Taylor & Francis Group 2018-01-01
Series:Cogent Medicine
Subjects:
Online Access:http://dx.doi.org/10.1080/2331205X.2018.1469595
_version_ 1811181405041852416
author Paik Seong Lim
Yachung Jeng
author_facet Paik Seong Lim
Yachung Jeng
author_sort Paik Seong Lim
collection DOAJ
description Peripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is common in hemodialysis (HD) patients, while usually underdiagnosed because most patients were asymptomatic. Some evidence indicated that the currently accepted criteria of ankle-brachial index (ABI) for clinical diagnosis of PAD result in poor sensitivity in HD patients. Other evidence indicated a necessity on using a reconciling criterion of ABI in HD population. This study therefore examined the PAD incidence and medical conditions in a cohort of maintenance HD patients with intermediate ABI (in 0.9–1) compared to those with high ABI (1–1.3) and with abnormal ABI (≤0.9). The Cox regression analysis on our cohort of HD patients showed that patients with intermediate ABI had significantly higher PAD incidence than those with high ABI (hazard ratio [95% confidence interval]: 4 [1.9–8.4]). The distribution of common medical conditions related to PAD, e.g., diabetes mellitus, cerebrovascular disease, body mass index, fasting blood sugar, and triglyceride, was significantly different between patients with intermediate ABI and high ABI, while no significant difference was observed between those with intermediate ABI and abnormal ABI. The results suggested that an ABI cutoff point of 1, instead of the conventionally used 0.9, could be considered for earlier detection of asymptomatic PAD and atherosclerosis prevention in HD patients.
first_indexed 2024-04-11T09:17:12Z
format Article
id doaj.art-899cdbeb8d5a42a3840b0faa4b82284e
institution Directory Open Access Journal
issn 2331-205X
language English
last_indexed 2024-04-11T09:17:12Z
publishDate 2018-01-01
publisher Taylor & Francis Group
record_format Article
series Cogent Medicine
spelling doaj.art-899cdbeb8d5a42a3840b0faa4b82284e2022-12-22T04:32:18ZengTaylor & Francis GroupCogent Medicine2331-205X2018-01-015110.1080/2331205X.2018.14695951469595A reconciling criterion for early detection of asymptomatic PAD in HD patientsPaik Seong Lim0Yachung Jeng1Tungs’ Taichung MetroHarbor HospitalTungs’ Taichung MetroHarbor HospitalPeripheral arterial disease (PAD), an important manifestation of systematic atherosclerosis, is common in hemodialysis (HD) patients, while usually underdiagnosed because most patients were asymptomatic. Some evidence indicated that the currently accepted criteria of ankle-brachial index (ABI) for clinical diagnosis of PAD result in poor sensitivity in HD patients. Other evidence indicated a necessity on using a reconciling criterion of ABI in HD population. This study therefore examined the PAD incidence and medical conditions in a cohort of maintenance HD patients with intermediate ABI (in 0.9–1) compared to those with high ABI (1–1.3) and with abnormal ABI (≤0.9). The Cox regression analysis on our cohort of HD patients showed that patients with intermediate ABI had significantly higher PAD incidence than those with high ABI (hazard ratio [95% confidence interval]: 4 [1.9–8.4]). The distribution of common medical conditions related to PAD, e.g., diabetes mellitus, cerebrovascular disease, body mass index, fasting blood sugar, and triglyceride, was significantly different between patients with intermediate ABI and high ABI, while no significant difference was observed between those with intermediate ABI and abnormal ABI. The results suggested that an ABI cutoff point of 1, instead of the conventionally used 0.9, could be considered for earlier detection of asymptomatic PAD and atherosclerosis prevention in HD patients.http://dx.doi.org/10.1080/2331205X.2018.1469595asymptomaticankle-brachial indexhemodialysisperipheral arterial disease
spellingShingle Paik Seong Lim
Yachung Jeng
A reconciling criterion for early detection of asymptomatic PAD in HD patients
Cogent Medicine
asymptomatic
ankle-brachial index
hemodialysis
peripheral arterial disease
title A reconciling criterion for early detection of asymptomatic PAD in HD patients
title_full A reconciling criterion for early detection of asymptomatic PAD in HD patients
title_fullStr A reconciling criterion for early detection of asymptomatic PAD in HD patients
title_full_unstemmed A reconciling criterion for early detection of asymptomatic PAD in HD patients
title_short A reconciling criterion for early detection of asymptomatic PAD in HD patients
title_sort reconciling criterion for early detection of asymptomatic pad in hd patients
topic asymptomatic
ankle-brachial index
hemodialysis
peripheral arterial disease
url http://dx.doi.org/10.1080/2331205X.2018.1469595
work_keys_str_mv AT paikseonglim areconcilingcriterionforearlydetectionofasymptomaticpadinhdpatients
AT yachungjeng areconcilingcriterionforearlydetectionofasymptomaticpadinhdpatients
AT paikseonglim reconcilingcriterionforearlydetectionofasymptomaticpadinhdpatients
AT yachungjeng reconcilingcriterionforearlydetectionofasymptomaticpadinhdpatients