Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 4 (1), 128-34

Significant Correlation Between Ankle-Brachial Index and Vascular Access Failure in Hemodialysis Patients


Significant Correlation Between Ankle-Brachial Index and Vascular Access Failure in Hemodialysis Patients

Szu-Chia Chen et al. Clin J Am Soc Nephrol.


Background and objectives: Vascular access failure (VAF) is associated with increased morbidity and mortality in hemodialysis patients. The most common cause of VAF is stenosis at the arteriovenous anastomosis because of abnormal neointimal proliferation and extracellular matrix deposition. These two changes are also observed in the classic atheroma, which means atherosclerotic lesions and venous stenosis in VAF may share some similar pathogenic mechanisms. The ankle-brachial index (ABI) is a reliable marker for atherosclerosis. The aim of this study was to evaluate the relationship between ABI <0.9 and VAF.

Design, setting, participants, & measurements: All routine hemodialysis patients in one regional hospital were included except for six patients refusing ABI examinations and four patients with atrial fibrillation. Finally, 225 patients formed our study group. The study subjects were observed from arteriovenous access creation until the first episode of VAF. The mean observation period was 42.2 +/- 42.8 mo. The relative VAF risk was analyzed by Cox-regression methods with adjustments for demographic and comorbid conditions.

Results: VAF episodes were recorded in 111 patients. In multivariate analysis, ABI <0.9 (hazard ratio, 1.893; P = 0.039), vascular access type of arteriovenous graft (P = 0.004), and serum triglyceride level (P = 0.043) were positively associated with VAF, and serum parathyroid hormone level (P = 0.043) was negatively associated with VAF.

Conclusions: Our findings show that ABI <0.9 is significantly correlated with increased VAF. Screening hemodialysis patients by means of ABI may help to identify a high-risk group for VAF.


Figure 1.
Figure 1.
Adjusted vascular access survival (Cox)* by ankle-brachial index (ABI) in hemodialysis patients. *Covariates in the model included age, gender, vascular access type, the presence of diabetes mellitus, systolic BP, pulse pressure, body mass index, serum triglyceride, creatinine, and parathyroid hormone level.

Similar articles

See all similar articles

Cited by 9 PubMed Central articles

See all "Cited by" articles

MeSH terms

LinkOut - more resources