Clinical Characteristics of Patients on Hemodialysis With Peripheral Arterial Disease.

AbstractPatients on hemodialysis (HD; n ¼ 210) were examined for peripheral arterial disease (PAD) using ankle-brachial index (ABI) andtoe-brachial index (TBI). The prevalence of PAD was 38.1%. Among patients with PAD, 87.5% were newly diagnosed with PAD,42.5% were diagnosed with TBI <0.6 despite ABI " 0.9, and 68.7% had no lower limb symptoms. In patients with PAD, theprevalence rate of cerebrovascular disease was 36.3%, coronary artery disease was 42.5%, spinal stenosis was 33.2%, and ver-tebral fracture 15.0% and was significantly higher than those of the non-PAD patients. Low high-density lipoprotein cholesterolwas the most important biomarker among patients with PAD. PAD has been underdiagnosed and untreated in patients on HDbecause most patients do not have symptoms that could be due to diabetic neuropathy or have insufficient daily activity toexperience exertional leg symptoms. Screening for PAD using the ABI and TBI increased diagnostic efficiency in patients on HDand may lead to effective early treatments, including pharmacotherapy, revascularization therapy, and exercise rehabilitation toavoid the worst possible scenario such as lower limb amputation, cardiovascular event, and death.Keywordsperipheral arterial disease, hemodialysis, arteriosclerosis, ankle-brachial index, toe-brachial index