Macedonian Journal of Medical Sciences
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Abstract                                                                         [Full-Text PDF] [Macedonian Abstract] [OnlineFirst Full-Text PDF]


Macedonian Journal of Medical Sciences. 2008 Sep 15; 1(1):44-49.


Clinical Science


Different Ankle Brachial Index Levels in Asymptomatic Hemodialysis Patients


Saso Gelev1, Goce Spasovski1, Sonja Dzikova1, Slavcho Tosev2, Marjan Bosevski2, Gjulsen Selim1, Pavlina Dzekova1, Arben Asani1, Vili Amitov1, Aleksandar Sikole1

1Department of Nephrology; 2Department of Cardiology; Clinical Center, Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia


Resting ankle brachial systolic pressure index (ABI) level of 0.90 is 95% sensitive in detecting angiogram-positive peripheral arterial disease (PAD) and that falsely elevated pressures or incompressible arteries at the ankle level and ABI > 1.30 is caused by mediosclerosis. We evaluated 94 hemodialysis (HD) patients for the presence of PAD and mediosclerosis using ABI measurement, and the presence of atherosclerotic lesions using high resolution B-mode ultrasonography of the common carotid (CCA) and femoral arteries (FA). Asymptomatic HD patients with high ABI (mediosclerosis) and low ABI (PAD) levels were common. Patients with normal and high ABI levels had high percentage of atherosclerotic lesions. Older age, diabetes and low serum albumin, and higher doses of prescribed calcium carbonate were associated (p<0.05) with low levels of ABI in our HD patients. Male gender, higher blood pressure and presence of diabetes were associated (p<0.05) with high ABI levels. Low and high ABI levels were not associated with the specific risks such as elevated serum phosphate, calcium phosphate product and intact parathyroid hormone levels. Arterial disease in asymptomatic HD patients is frequent. Screening for atherosclerotic lesions in HD patients should be recommended even if they had no symptoms.


Key words: Hemodialysis; arterial disease; ankle brachial index.


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