Endocrine Abstracts

Introduction: Peripheral arterial disease (PAD) is increased associated with an accumulation of patients with end stage kidney disease and diabetes. Recently, the cardio-ankle vascular index (CAVI) has been developed as an index reflecting the stiffness of the aorta independently of blood pressure. The aim of this study was to assess the prevalence of PAD in hemodialysis patients with diabetes.

Methods: To examine the usefulness of CAVI to screen for the presence of PAD, cross-sectional studies were performed on 94 patients undergoing chronic hemodialysis. Patients were referred to echocardiography or analyzed HbA1c and a blood inflammatory marker, high-sensitivity C-reactive protein (hs CRP). We also analyzed the ankle brachial index (ABI) and values of skin perfusion pressure (SPP) in all patients.

Results: CAVI significantly correlated to age but not blood pressure. CAVI in diabetics was significantly higher than that in non-diabetics. In contrast, ABI or SPP was no differences between diabetics and non-diabetics. Furthermore, CAVI was markedly elevated in patients with a history of PAD or cardiovascular disease. When diabetic patients were classified on the basis of CAVI quartiles, the odds ratio for the prevalance of PAD was increased. Increased CAVI was also associated with other risk factors for PAD (HbA1c, hs CRP, body mass index or history of PAD). However, the association with HbA1c was not observed in ABI.

Conclusion: The prevalence of PAD is high in diabetic elderly patients with hemodialysis. The present findings suggest that CAVI can be useful index that predicts the occurrence of microvascular complications in dialysis patients with diabetes.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.