Cardio-ankle vascular index to screen cardiovascular diseases in patients with end-stage renal diseases

Abstract

Background: Cardiovascular diseases constitute major causes of death in patients with chronic kidney diseases. An increase in arterial stiffness predicts the presence of cardiovascular diseases; however, non-invasive arterial stiffness parameters such as pulse wave velocity are confounded by blood pressure. Methods: A new arterial stiffness parameter β for the arterial tree, cardio-ankle vascular index (CAVI), was measured. To examine the usefulness of CAVI to screen for the presence of cardiovascular diseases, cross-sectional studies were performed on 68 patients undergoing chronic hemodialysis. Results: Stepwise regression analysis indicated that CAVI significantly correlated to age (β = 0.05, p< 0.01) but not blood pressure. In addition, CAVI was higher in diabetics than non-diabetics (8.39± 0.37 vs 7.63±0.57, p<0.05). Furthermore, CAVI was markedly elevated in patients with a history of cardiovascular diseases (8.69±0.23 vs 6.66±0.28, p<0.01). Analysis using the ROC curve has demonstrated that CAVI of 7.55 constitutes the cut-off value for the presence of cardiovascular diseases with both sensitivity and specificity of 0.79. Conclusion: The present findings suggest that CAVI can be used as a screening test to detect for the presence of cardiovascular diseases in patients undergoing hemodialysis.