Ankle-arm blood pressure index as a predictor of mortality in hemodialysis patients

被引:80
作者
Fishbane, S
Youn, S
Flaster, E
Adam, G
Maesaka, JK
机构
[1] WINTHROP UNIV HOSP, DIV NEPHROL, MINEOLA, NY 11501 USA
[2] SUNY STONY BROOK, SCH MED, DEPT MED, STONY BROOK, NY 11794 USA
关键词
mortality; cardiovascular disease; hemodialysis;
D O I
10.1016/S0272-6386(96)90101-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The ankle-arm blood pressure index (AAI, ratio of ankle to arm systolic blood pressure), a simple, noninvasive, and inexpensive screening test, has recently been found to be highly predictive of subsequent mortality in several populations. The purpose of this study was to evaluate the relationship of the AAI to cardiovascular and all-cause mortality in hemodialysis patients, A cohort of 132 patients was followed for 1 year. The primary outcome measures were cardiovascular and all-cause mortality, An AAI of <0.9 was associated with a relative risk (RR) of cardiovascular mortality of 7.5, (95% CI, 2.3 to 24.8), Other predictive variables included diabetes mellitus RR 3.0, (95% CI, 1.2 to 7.3), and a history of any vascular disease RR 2.6 (95% CI, 1.0 to 7.0). An AAI of <0.9 was also predictive of all-cause mortality, RR 2.4 (95% CI, 1.2 to 4.7). Other predictive variables for all-cause mortality included older age, RR 1.4 per 10 years (95% CI, 1.0 to 2.1), decreased serum albumin RR 0.9 per 0.1 mg/dL (95% CI, 0.8 to 1.0), and diabetes mellitus RR 2.0 (95% CI, 1.0 to 3.7), Multivariate analysis showed an AAI of <0.9 and diabetes mellitus to be the only independent predictors of cardiovascular mortality, and an AAI of <0.9, older age, and a decreased serum albumin were independent predictors of all-cause mortality, In conclusion, we have found an AAI of <0.9 to be a powerful, independent predictor of mortality in hemodialysis patients. (C) 1996 by the National Kidney Foundation, Inc.
引用
收藏
页码:668 / 672
页数:5
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