RELATIONSHIP BETWEEN INFLAMMATION AND PERIPHERAL ARTERIAL DISEASE MEASURED BY ANKLE-BRACHIAL INDEX IN CHRONIC HEMODIALYSIS PATIENTS

Abstract Background and Aims Peripheral arterial disease (PAD) is very common in patients with chronic kidney disease. There are predisposing factors such as high blood pressure, diabetes mellitus, and dyslipidemia that are highly prevalent in this population. The ankle-brachial index (ABI) is a widely validated diagnostic method for the diagnosis of PAD. A value below 0.9 is suggestive of this pathology. On the other hand, inflammation is a phenomenon that favors development of atherosclerosis and therefore could be another predisposing factor for PAD. There are emerging markers of inflammation such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) that have an excellent correlation with classic markers such as C-reactive protein (CRP). The objective of our study was to determine whether there is a relationship between ABI values and the degree of inflammation in patients. Method A retrospective observational cross-sectional study was conducted in our prevalent hemodialysis population between April-May 2019. ABI was measured through the Microlife WatchBP Office ABI™ device. The sample was divided into two groups using 0.9 as a cut-off point: group 1 (ABI <0.9) and group 2 (ABI> 0.9). Inflammatory ratios (NLR, PLR and SII) and other parameters of bone kidney disease such as serum calcium, bicarbonate, phosphorus, parathyroid hormone (PTH), magnesium and vitamin D were determined. Results 100 patients with chronic kidney disease on chronic hemodialysis belonging to our Avericum Negrin center were analyzed. 42% (N = 42) of the sample were women and 42% (N = 42) were diabetic. The etiology of kidney disease was: 12% (N = 12) renal nephroangiosclerosis, 35% (N = 35) diabetic nephropathy, 14% (N = 14) chronic glomerulonephritis, 8% (N = 8) polycystic kidney disease, 17% (N = 17) unknow and 14% (N = 14) others. 19% (N = 19) had a central venous catheter as vascular access. The mean values of inflammatory and renal bone disease parameters are described in Table 1. The values of PLR and SII index were significantly higher in patients with ABI <0.9. (Figures 1 and 2). Conclusion Patients with peripheral arterial disease (ABI <0.9) had higher PLR and SII values