Chen J, He H, Starcke CC, et al. - For classifying peripheral artery disease (PAD), defined as ≥ 50% stenosis detected by Doppler ultrasound, in patients with chronic kidney disease (CKD), current ankle-brachial index (ABI) and toe-brachial index (TBI) diagnostic criteria have high specificity but low sensitivity. PAD classification risk score based on cardiovascular disease risk factors enhances the accuracy of PAD classification.

• In 100 predialysis patients with CKD who had not undergone revascularization or amputation, ABI, TBI, and Doppler ultrasound were measured.

• The area under the curve for distinguishing ultrasound-diagnosed PAD was 0.78 by ABI, 0.80 by alternative ABI, and 0.74 by TBI.

• It was noted that sensitivity and specificity were 25% and 97% for ABI ≤ 0.9, 41% and 95% for alternative ABI ≤ 0.9, and 45% and 93% for TBI ≤ 0.7.

• Findings revealed that the AUC of PAD risk classification score was 0.86 with sensitivity and specificity of 95% and 60% for risk score ≥ 0.10, 76% and 76% for risk score ≥ 0.25, and 43% and 95% for risk score ≥ 0.55, respectively.

• Combining risk scores with ABI, alternative ABI, and TBI rose AUC to 0.89, 0.89, and 0.87, respectively.