Background. Ankle-brachial index (ABI) is a marker for peripheral artery disease and can predict mortality in advanced chronic kidney disease (CKD) and hemodialysis patients, respectively. However, it is seldom studied in Taiwan, an area with high prevalence of CKD and end-stage renal disease. The aim of this study was to investigate the predictors for mortality via using ABI value in patients with CKD and hemodialysis in Taiwan.
Methods. We enrolled 169 patients with CKD stage 3–5 and 231 hemodialysis patients in one regional hospital. The mean follow-up period was 23.3 ± 3.3 months. Patients were stratified into three groups according to ABI value (< 0.9, ≥ 0.9 to < 1.3, and ≥ 1.3). The relative mortality risk was analyzed by Cox-regression methods.
Results. In multivariate analysis, ABI ≥ 1.3 (hazard ratio, 3.846; P= 0.043), and coronary artery disease (P= 0.012) were positively associated with overall mortality, and serum low-density lipoprotein cholesterol level (P= 0.042) was negatively associated with overall mortality. In addition, ABI < 0.9 (P= 0.049), ABI ≥ 1.3 (P= 0.033), coronary artery disease (P= 0.024) and hemodialysis treatment (P= 0.043) were strong predictors for cardiovascular mortality.
Conclusions. Our findings show that ABI ≥ 1.3 predicts for both overall and cardiovascular mortality, and ABI < 0.9 predicts for cardiovascular mortality in CKD and hemodialysis patients. Screening patients with chronic renal failure by means of ABI may help to identify a high risk group for increased mortality.