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ȣ - 540301 111 |
| A high ankle brachial index is associated with decreased renal function. |
| 충남대학교 의전원, 충남 대학교 병원 심장내과, 대전충남권역심뇌혈관센터 |
| 신성균, 박재형, 박용규, 진선아, 김규섭, 정일순, 김준형, 이재환, 최시완, 정진옥, 성인환 |
Background: An ankle brachial index (ABI) is usually used to detect the presence of peripheral arterial occlusive disease. A high ankle brachial index (ABI) indicates stiff peripheral arteries and is associated with increased cardiovascular diseases. In the subjects with end-stage renal disease undergoing hemodialysis showed increased aortic stiffness. However, the association between arterial stiffness and kidney function is unclear. We evaluated the association of high ABI and glomerular filtration rate (GFR) calculated by MDRD method.
Methods: We evaluated the data from 2834 subjects without end-stage renal disease from January 2008 to December 2009. We compared their laboratory and pulse wave velocity (PWV) data according to the ABI groups (low (<0.9), normal (0.9~1.3), and high group (>1.3)). GFR was calculated by MDRD method; GFR (mL/min/1.73 m²) = 186 x (Scr)^-1.154 x (Age)^-0.203 x (0.742 if female).
Results: Of total 2690 subjects, 286 showed a low ABI and 64 had a high ABI. The incidence of chronic kidney disease (GFR <60ml/min/m²) was 19.9% (537 patients). Compared with normal ABI group, low and high ABI groups showed higher serum creatinine level, lower GFR, and higher brachial to ankle PWV (baPWV) (table). The high ABI group showed lower age (p=0.026), lower LDL-cholesterol level (p<0.001) and higher baPWV velocities (p=0.026 and p-0.014) than the low ABI group. However, other blood chemistry values were similar.
Table 1. Characteristics according to ABI
|
|
Low ABI
(n=286) |
Normal ABI
(n=2340) |
High ABI
(n=64) |
p value |
|
Age (years) |
70.7±9.7 |
65.3±11.4 |
67.7±10.5 |
<0.001 |
|
BUN (mg/dL) |
22.8±18.2 |
17.0±12.7 |
23.4±20.5 |
<0.001 |
|
Creatinine (mg/dL) |
1.7±1.9 |
1.2±1.5 |
2.1±2.4 |
<0.001 |
|
GFR (ml/min/ m2) |
66.5±36.5 |
83.0±31.2 |
70.8±39.7 |
<0.001 |
|
LDL-cholesterol (mg/dL) |
103.4±36.0 |
97.2±32.9 |
86.5±34.9 |
0.003 |
|
Triglyceride (mg/dL) |
128.1±73.6 |
137.8±90.7 |
125.9±82.5 |
0.148 |
|
HDL-cholesterol (mg/dL) |
42.7±9.7 |
44.8±9.6 |
43.9±11.3 |
0.008 |
|
Right baPWV (cm/s) |
1840.5±598.9 |
1833.7±480.7 |
2035.9±621.7 |
<0.001 |
|
Left baPWV (cm/s) |
1817.5±574.0 |
1832.5±470.5 |
2020.1±547.5 |
<0.001 |
|
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