{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:26:08Z","timestamp":1762917968672,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T00:00:00Z","timestamp":1549584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 DK114556"],"award-info":[{"award-number":["K23 DK114556"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["Merit IIR 15\u2010369"],"award-info":[{"award-number":["Merit IIR 15\u2010369"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p><jats:bold>Introduction<\/jats:bold>: The ankle\u2010brachial index (ABI) is the most common test to diagnose peripheral artery disease (PAD). In dialysis patients, the ABI may under\u2010diagnose PAD, due to a high prevalence of concomitant medial arterial calcification (MAC). The toe\u2010brachial index (TBI) is not as susceptible to misclassification by MAC. Taking the ABI and TBI together in the form of their difference, the ABI\u2010TBI, may provide a single measure for assessing both atherosclerosis and calcification. The relationship of these variables in dialysis patients has not been well studied.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: We identified 37 dialysis patients referred for vascular studies between 2009 and 2017 in the San Diego Veterans Administration Medical Center (SDVAMC). The ABI and TBI were performed systematically for each patient, and TBI was performed regardless of ABI or waveform. We examined associations between ABI, TBI, and the difference between them (ABI\u2010TBI) with all\u2010cause mortality and major adverse limb events (MALE), which includes revascularizations and amputations.<\/jats:p><jats:p><jats:bold>Findings<\/jats:bold>: The mean age was 65 years and 30% were African American. All patients were men, reflecting the Veterans Administration population. There were 26 deaths during follow\u2010up and mortality was highest in patients who had low ABI and low TBI and least in those with high ABI and high TBI. Persons with TBI &lt; 0.7 had an increased risk of all\u2010cause mortality. The ABI\u2010TBI, and the ABI itself, were not significantly associated with all\u2010cause mortality although the patterns were similar.<\/jats:p><jats:p><jats:bold>Discussion<\/jats:bold>: Although ABI may be an important initial risk stratification tool, the TBI may be a more informative predictor of mortality in dialysis patients. Strengths of this study include a high rate of MALE and deaths. The TBI, and the difference between ABI and TBI, should be studied further in a larger cohort of persons with advanced kidney disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.12734","type":"journal-article","created":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T11:01:34Z","timestamp":1549623694000},"page":"214-222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The association of the ankle\u2010brachial index, the toe\u2010brachial index, and their difference, with mortality and limb outcomes in dialysis patients"],"prefix":"10.1111","volume":"23","author":[{"given":"Ritika","family":"Prasad","sequence":"first","affiliation":[{"name":"School of Medicine University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thejas","family":"Kamath","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Ginsberg","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O. Alison","family":"Potok","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim H.","family":"Ix","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego  San Diego California USA"},{"name":"Veterans' Administration Healthcare System  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6016-4715","authenticated-orcid":false,"given":"Pranav S.","family":"Garimella","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dena E.","family":"Rifkin","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego  San Diego California USA"},{"name":"Veterans' Administration Healthcare System  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.12.037"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2008.07.007"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00279127"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv114"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg414"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34885"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00404070"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.12.3333"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.174526"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358836X9900400103"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.608679"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.04.044"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318276fbcb"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.03.044"},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2017","author":"R Core Team","key":"e_1_2_7_16_1"},{"key":"e_1_2_7_17_1","first-page":"204","article-title":"Ankle\u2010brachial index as a predictor of mortality in hemodialysis: A 5\u2010year cohort study","volume":"108","author":"Miguel JB","year":"2017","journal-title":"Arq Bras Cardiol"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2009.00663.x"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhdi.12734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.12734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hdi.12734","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.12734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:57:41Z","timestamp":1694365061000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.12734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,8]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/hdi.12734"],"URL":"https:\/\/doi.org\/10.1111\/hdi.12734","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"type":"print","value":"1492-7535"},{"type":"electronic","value":"1542-4758"}],"subject":[],"published":{"date-parts":[[2019,2,8]]},"assertion":[{"value":"2018-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}