Abstract: TH-PO0298
Association Between Ankle-Brachial Index and Progression of CKD in Patients with Hypertension
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Kim, Taeeun, Department of Pathology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
- Ko, Ye Eun, Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
- Jhee, Jong Hyun, Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
- Yoo, Tae-Hyun, Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
Background
The ankle-brachial index (ABI), a widely used tool for diagnosing peripheral arterial disease, reflects systemic atherosclerosis and endothelial dysfunction. Endothelial dysfunction has been implicated in the development and progression of chronic kidney disease (CKD). However, the relationship between ABI and CKD progression in patients with hypertension remains unclear. This study aimed to evaluate the association between ABI and CKD progression in a prospective cohort of hypertensive patients.
Methods
A total of 2,429 hypertensive patients from the Cardiovascular and Metabolic Disease Etiology Research Center–High Risk (CMERC-HI) cohort were included. Participants were stratified into quartiles based on ABI: A1 (<1.11), A2 (1.11–1.17), A3 (1.17–1.23), and A4 (>1.23). The primary outcome was CKD progression, defined as a ≥50% decline in estimated glomerular filtration rate (eGFR) from baseline, development of end-stage kidney disease requiring dialysis, or new-onset CKD (eGFR <60 mL/min/1.73 m^2).
Results
The mean age of the study population was 60.1±11.3 years, and 55.4% were male. The prevalence of diabetes mellitus increased across ABI quartiles (40.1%, 41.1%, 43.7%, and 51.7% from A1 to A4; P < 0.001). Significant differences were observed in baseline hemoglobin (P = 0.002) and albumin levels (P = 0.01) among the ABI groups, while other clinical parameters showed no significant differences. Over a median follow-up period of 42.5 months, 490 patients (20.2%) experienced CKD progression. In multivariate Cox regression analysis, the A1 and A3 groups demonstrated significantly increased risks of CKD progression compared to the A2 group (HR 2.28; 95% CI 1.30–4.00; P = 0.004 and HR 2.22; 95% CI 1.27–3.90; P = 0.005, respectively). Furthermore, low ABI remained independently associated with a higher risk of CKD progression after adjusting for age, sex, diabetes, baseline eGFR, and other confounding variables (HR 1.57; 95% CI 1.04–2.38; P = 0.03).
Conclusion
ABI may serve as an independent predictor of CKD progression in hypertensive patients.