Ischemic Peripheral Circulatory Disorders and Ankle Brachial Pressure Index in Maintenance Hemodialysis Patients / 日本農村医学会雑誌

ABSTRACT

Ischemic peripheral circulatory disorders have been observed more and more frequently in maintenance hemodialysis patients in recent years. This tendency is associated with the progression of arteriosclerosis characteristic of such patients. In the present study, we made inquiries about the presence or absence of subjective symptoms of ischemic peripheral circulatory disorders in maintenance hemodialysis patients and examined pulsation of dorsal artery and cyanosis of foot to make early diagnosis of the circulatory disorders possible. Furthermore, we measured the ankle brachial pressure index (API) and examined the calcification in thoracic and abdominal aortae on X-rays. According to clinical symptoms, the subjects were classified into no clinical symptom, sensory disorder, and motor disorder. Of the participants in the present study, 31.0% had API below 1.0. The mean age and hemodialysis period of the patients with API below 1.0 were more than those of the patients with API 1.0 or over. However, the differences were not significant. Of the patients with no clinical symptom, 21.2% had API below 1.0. We found a patient with no clinical symtom who had no pulsation of dorsal artery and cyanosis of foot. Of the patients who complained sensory and motor disorders, 35.0% and 45.5%, respectively, had API below 1.0. In the examination of calcification of thoracic and abdominal aortae, 23.8% of the patients with no calcification, 22.2% of the patients with the calcification in thoracic aorta alone, 27.8% of the patients with the calcification in abdominal aorta alone, and 29.6% of the patients with the calcification in both thoracic and abdominal aortae had API below 1.0. We believe that these results will make for early diagnosis and care treatment of ischemic peripheral circulatory disorders in hemodialysis patients.