Related Experiment Video

Updated: Jul 17, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.3K

Implications of Kidney Disease in Patients with Peripheral Arterial Disease and Vascular Calcification

Yogamaya Mantha1, Anum Asif1, Ayman Fath1

  • 1Division of Cardiology, Department of Medicine, UT Health San Antonio, MC 7872, 8300 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.

Interventional Cardiology Clinics
|September 6, 2023
PubMed

Insights

Patients with chronic kidney disease (CKD) have a higher risk of peripheral artery disease (PAD), including critical limb ischemia (CLI). Vascular calcification is a key issue, and optimal revascularization treatments for CKD patients remain unproven.

Area of Science:

  • Nephrology
  • Vascular Biology
  • Cardiovascular Medicine

Background:

  • Chronic kidney disease (CKD) significantly elevates the risk of peripheral artery disease (PAD) compared to individuals with normal kidney function.
  • PAD in CKD patients is marked by medial arterial calcification, intimal atherosclerosis, and calcification, driven by CKD-related metabolic derangements and inflammation.
  • Vascular calcification (VC) affects over 80% of dialysis patients and 50% of CKD patients, leading to arterial stiffening and symptomatic PAD.

Purpose of the Study:

  • To highlight the increased prevalence and severity of PAD in CKD patients.
  • To underscore the role of vascular calcification in CKD-associated PAD and critical limb ischemia (CLI).
  • To identify the lack of evidence-based guidelines for revascularization in this high-risk population.

Main Methods:

  • Literature review focusing on the pathophysiology of PAD in CKD.
  • Analysis of the prevalence and clinical impact of vascular calcification in CKD patients.
  • Examination of current endovascular treatment options for severe calcific PAD.

Main Results:

  • CKD patients exhibit a higher incidence of PAD and its severe manifestation, CLI.
  • Hyperphosphatemia, hypercalcemia, elevated parathyroid hormone (PTH), inflammation, and oxidative stress are key drivers of VC in CKD.
  • VC contributes significantly to arterial non-compliance and symptomatic PAD, increasing morbidity and mortality.

Conclusions:

  • PAD and CLI pose substantial risks to CKD patients, largely due to prevalent vascular calcification.
  • Current nonsurgical treatments for severe calcific PAD include angioplasty, atherectomy, and intravascular lithotripsy.
  • There is a critical need for randomized controlled trials to establish optimal revascularization strategies for PAD and CLI in patients with CKD.

Keywords:
AtherectomyChronic kidney diseaseCritical limb ischemiaIntravascular lithotripsyMedial calcificationPeripheral arterial diseasePeripheral vascular intervention

More Related Videos

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation08:43

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

Published on: May 31, 2016

19.6K
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro11:30

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro

Published on: June 2, 2022

2.0K

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
17
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
9
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
29
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
12
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11