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. 2013;6(1):52-6.
doi: 10.3400/avd.oa.12.00070. Epub 2012 Dec 26.

Exercise-ankle brachial pressure index with one-minute treadmill walking in patients on maintenance hemodialysis

Kazuo Tsuyuki  1 , Kenji Kohno, Kunio Ebine, Takehiro Obara, Toshiyuki Aoki, Atsuhiko Muto, Kenji Ninomiya, Kenta Kumagai, Itaru Yokouchi, Yoshiyuki Yazaki, Shinichi Watanabe
Affiliations

Exercise-ankle brachial pressure index with one-minute treadmill walking in patients on maintenance hemodialysis

Kazuo Tsuyuki et al. Ann Vasc Dis. 2013.

Abstract

Background: The ankle-brachial pressure index (ABI) is widely used as a standard screening method for arterial occlusive lesion above the knee. However, the sensitivity of ABI is low in hemodialysis (HD) patients. Exercise stress (Ex-ABI) may reduce the false negative results.

Patients and methods: After measuring resting ABI and toe-brachial pressure index (TBI), ankle pressure and ABI immediately after walking (Post-AP, Post-ABI) were measured using one-minute treadmill walking in 52 lower limbs of 26 HD patients. The definition of peripheral arterial occlusive disease (PAD) required an ABI value of less than 0.90, TBI value of less than 0.60, and decrease of more than 15% of the Post-ABI value and 20 mmHg of Post-AP in Ex-ABI. Computed tomographic angiography (CTA) was performed in 32 lower limbs of 16 HD patients. PAD is defined as presence of stenosis of more than 75% in the case of lesions from an iliac artery to knee on CTA.

Results: The accuracy of Ex-ABI (Sensitivity, 85.7%; Specificity, 77.7%) was higher than those of ABI (Sensitivity, 42.9%; Specificity, 83.3%) or TBI (Sensitivity, 78.6%; Specificity, 61.1%).

Conclusion: Ex-ABI with one-minute treadmill walking is the most useful tool for the screening of arterial occlusive lesions above the knee in maintenance HD patients.

Keywords: diagnosis; exercise; hemodialysis; peripheral arterial disease; screening.

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Figures

Fig. 1
Fig. 1
Changes of brachial, ankle pressure and ankle-brachial pressure index (ABI) between pre and post one-minute treadmill walking in HD patients.
Fig. 2
Fig. 2
Test positive rates on 3 non-invasive measurements (ABI, TBI and Ex-ABI) in HD patients.
See this image and copyright information in PMC

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