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Abstract: TH-PO1132

Ankle Brachial Index Is Associated with Cardiovascular and Renal Events in Patients with CKD: Result from the KNOW-CKD Study

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Kim, Chang Seong, Chonnam National University Hospital, Gwangju, Korea (the Republic of)
  • Choi, Hong sang, Chonnam National University Hospital, Gwangju, Korea (the Republic of)
  • Bae, Eun Hui, Chonnam National University Hospital, Gwangju, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Korea (the Republic of)
Background

Vascular calcification of the media is an independent and strong predictor of cardiovascular risk in patients with chronic kidney disease (CKD). Ankle brachial index (ABI) is a useful tool for diagnosis of medial calcification as well as peripheral artery disease. However, few studies are reported its relation to the renal progression and risk of cardiovascular events in patients with CKD. We examined this relationship in a large CKD cohort.

Methods

In this prospective longitudinal study, we enrolled 2115 patients from the KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD). The patients were categorized into low ABI (≤ 0.9), borderline ABI (0.9−1.1), normal ABI (1.1−1.3), or high ABI (≥ 1.3). The relationship between ABI and cardiovascular events (myocardial infarction, stroke, cerebral hemorrhage, or congestive heart failure), renal progression (as ≥ 50% decline of estimated glomerular filtration rate (eGFR), doubling of serum creatinine, or start of dialysis) was analyzed using Cox regression.

Results

Renal progression and cardiovascular events were occurred 330 (15.6%) and 86 (4.3%) in patients, respectively, during the median follow-up of 26.9 months. Compared to patients with high ABI, patients with low ABI had a lower prevalence of renal progression (low ABI: 17.5% vs. high ABI: 24.7%), whereas had a higher risk of cardiovascular events (low ABI: 17.3% vs. high ABI: 7.2%). In Cox regression model, patients with low ABI were at higher risk of cardiovascular events even after adjustments (hazard ratio [HR], 4.41; 95% confidence interval [CI], 1.63−11.9; P = 0.003), but high ABI had no significant risk of cardiovascular events (HR, 1.18; 95% CI, 0.46−3.07; P = 0.731) than those with normal ABI. However, there was no significant association between patients with low or high ABI and a risk of renal progression after adjustment.

Conclusion

Low ABI (≤ 0.9) is related to higher risk of cardiovascular events in patients with CKD. Measuring ABI might serve as a useful tool for predicting cardiovascular events in Korean CKD patients.