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PVD is prevalent in patients on maintenance hemodialysis. Early detection helps in preventing the morbidity
associated with it. Current study evaluates the role of x-ray abdomen lateral view as a screening tool for detecting PVD in
Material and methods:
The study sample consisted of 44 prevalent hemodialysis patients. Patients were diagnosed to have
PVD if they had claudication, ischemic ulcers, lower limb amputation, revascularization or previous diagnosis of obstruction by
ultrasonography or angiography and ankle brachial index (ABI) <0.9 or >1.4. All patients above 18 yrs. of age on thrice weekly
maintenance hemodialysis for > 3 months were included, while those < 18 yrs. or bilateral lower limb amputations were excluded.
Mean hemoglobin, serum albumin, total protein, calcium, phosphorus, intact PTH, alkaline phosphatase and urea reduction
(URR) were noted from time of initiation till December 2012 .All patients underwent ABI study and X-ray abdomen lateral view.
Out of 44 patients, 20 met inclusion criteria. 65% were male. Mean age was 58.6 yrs. 70% were diabetics while 90% were
hypertensive. Average duration on hemodialysis was 10.7 months. 35% of patients had peripheral vascular disease. Average Hb
was 9.3 gm%, serum calcium 8.46 mg/dl, phosphorus 4.8 mg/dl, iPTH 341 pg/ml, URR 62.15%, total protein 6.04 gm/dl, and
albumin 3.08 gm/dl. 50% of patients were on calcium based phosphate binders. ABI was <0.9 in 25% while it was >1.4 in 10% of
patients. X-ray spine showed aortic calcification in 50% of patients. One patient with amputation did not have calcification on
x-ray but had positive ABI.
X-ray abdomen lateral view is a cheap and readily available screening tool for diagnosing PVD and needs to be
evaluated on a larger scale for early detection and risk reduction in dialysis patients.
Pranaw Kumar Jha has completed his M.D. (internal medicine) and DNB (nephrology) in 2011. He is at present working as a consultant nephrologist
in Department of nephrology and transplant medicine at Medanta hospital, India. He has publications in reputed national and international journals
to his credit
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