Abstract: FR-PO0429
Low Ankle-Brachial Index in Patients on Hemodialysis Is Associated with Elevated Serum Spermine Oxidase and C-Reactive Protein Levels
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Chang, Yu Chi, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Chang, Ho-Hsiang, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Hsu, Bang-Gee, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
Background
Peripheral arterial disease (PAD) is a significant cardiovascular complication in patients undergoing hemodialysis (HD), with inflammation and oxidative stress playing key roles. Spermine oxidase (SMOX), an enzyme that produces hydrogen peroxide during polyamine metabolism, has been implicated in vascular injury, but its association with PAD in HD patients remains unclear.
Methods
We conducted a cross-sectional study of 142 HD patients categorized by ankle-brachial index (ABI) into a normal group (ABI ≥ 0.9, n = 115) and a low ABI group (ABI < 0.9, n = 27). Ankle-brachial index (ABI) values were assessed by applying an automated oscillometric device, and patients with ABI values <0.9 were classified into the low ABI subgroup. Serum SMOX levels were quantified using a commercial enzyme-linked immunosorbent assay.
Results
Patients with low ABI were older (P = 0.002), had lower creatinine (P = 0.008) and albumin levels (P = 0.031), and elevated glucose (P = 0.005), C-reactive protein (CRP, P < 0.001), and SMOX (P < 0.001) compared to the normal ABI subgroup. Multivariable analysis showed SMOX (odds ratio [OR]: 1.091, 95% confidence interval [CI]: 1.064–1.162, P = 0.007) and CRP (OR: 1.237, 95% CI: 1.075–1.423, P = 0.003) as independent predictors of PAD. The receiver operating characteristic (ROC) analysis showed an area under the ROC (AUC) of 0.790 (95% CI: 0.675-0.906) for SMOX and 0.804 (95% CI: 0.701-0.907) for CRP (all P < 0.001). Log-transformed SMOX (log-SMOX) negatively correlated with left or right log-ABI (all P < 0.001) and positively with log-CRP (P < 0.001), while CRP and SMOX correlated with markers of malnutrition and dialysis adequacy.
Conclusion
Elevated serum SMOX and CRP levels are significantly associated with PAD in HD patients.