Peripheral arterial disease: a guide for nephrologists

Area of Science:

• Nephrology
• Cardiology
• Vascular Medicine

Background:

• Cardiovascular disease (CVD) is a leading cause of death in chronic kidney disease (CKD) patients.
• Peripheral arterial disease (PAD) is a significant predictor of coronary artery disease and mortality in the general population.
• CKD patients have an elevated risk of PAD, which is frequently underestimated.

Purpose of the Study:

• To provide a comprehensive overview of peripheral arterial disease (PAD) in patients with chronic kidney disease (CKD).
• To emphasize the epidemiology, screening, diagnosis, and treatment of PAD within the context of CKD.
• To highlight the importance of recognizing PAD as a source of morbidity and a cardiovascular risk factor in CKD.

Main Methods:

• Literature review focusing on epidemiological data, diagnostic strategies, and therapeutic interventions for PAD.
• Emphasis on studies and guidelines relevant to the CKD population.
• Synthesis of current knowledge on PAD management in nephrology.

Main Results:

• PAD prevalence is significantly higher in CKD patients compared to the general population.
• PAD is often asymptomatic or presents with non-specific symptoms in CKD patients, leading to delayed diagnosis.
• Screening for PAD is recommended in high-risk CKD patients.
• Aggressive management of cardiovascular risk factors is essential in CKD patients with PAD.

Conclusions:

• PAD represents a substantial and often under-recognized contributor to cardiovascular morbidity and mortality in CKD.
• Nephrologists play a critical role in the screening, diagnosis, and management of PAD in their patients.
• Integrated care approaches are necessary to address the complex cardiovascular risks in CKD patients with PAD.