ANKLE BRACHIAL PRESSURE INDEX AS AN INDICATOR OF RENAL FUNCTION IN CHRONIC KIDNEY DISEASE PATIENTS

Nandu Krishnan J., Selvarajan Chettiar K. P.*, Rakul Nambiar K. and Harish Sugathan

ABSTRACT

Background: Ankle brachial pressure index (ABI) is a simple and effective way to diagnose peripheral artery disease (PAD) in chronic kidney disease (CKD) patients to predict the cardiovascular morbidity and outcomes in them. Objective: ABI of CKD patients were recorded to find out if it could independently be used as an indicator of renal function and assess its relationship across increasing CKD stage severity. Study design: An observational cross sectional study based on a sample population of 100 CKD patients of stages 3-5 was performed. The demographic details were obtained using proforma and ABI calculated with the help of Doppler ultrasound and results were analysed using SPSS software. Chi-square test was used for categorical variables while independent ttest for continuous variables and multivariate forward logistic regression analysis to identify the independent determinant factors of low ABI. Results: ABI was <= 0.9 in 69% of the patients and 31 % had normal ABI > 0.9. A low ABI and low GFR correlated significantly (p value < 0.001) with increasing CKD stage severity along with other renal function parameters like urea, creatinine, uric acid, urine PC ratio, calcium, phosphorus and cholesterol. Unlike many studies ABI did not correlate well with diabetic status of the patients in my study while hypertension did. Conclusion: ABI being a marker of systemic atherosclerosis and vascular calcification can predict cardiovascular outcomes, and feasibility of vascular access and or failure of them in CKD patients while identifying those at high risk of progression to ESRD.

Keywords: Ankle brachial pressure index (ABI), chronic kidney disease (CKD), Peripheral artery disease (PAD).