Peripheral Artery Disease in CKD: Anatomically Peripheral But Clinically Central

Hishida, Manabu; Menez, Steven; Matsushita, Kunihiro

doi:10.1053/j.ajkd.2019.10.006

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…In this context, the terminology of "peripheral" in PAD may provide an impression that this clinical condition is not critical. 10 However, as noted later in this statement, this notion is clearly incorrect, because PAD is associated with various adverse outcomes. Thus, increasing awareness of all aspects of PAD, including the definition, diagnosis, clinical manifestation, and complications, is critical to improving overall outcomes among this growing and undertreated population.…”

Section: Awarenessmentioning

confidence: 98%

Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

Criqui¹,

Matsushita²,

Aboyans³

et al. 2021

Circulation

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419

234

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Lower extremity peripheral artery disease (PAD) affects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes (other cardiovascular diseases such as coronary heart disease and stroke and leg outcomes such as amputation). Despite its prevalence and clinical importance, PAD has been historically underappreciated by health care professionals and patients. This underappreciation seems multifactorial (eg, limited availability of the first-line diagnostic test, the ankle-brachial index, in clinics; incorrect perceptions that a leg vascular disease is not fatal and that the diagnosis of PAD would not necessarily change clinical practice). In the past several years, a body of evidence has indicated that these perceptions are incorrect. Several studies have consistently demonstrated that many patients with PAD are not receiving evidence-based therapies. Thus, this scientific statement provides an update for health care professionals regarding contemporary epidemiology (eg, prevalence, temporal trends, risk factors, and complications) of PAD, the present status of diagnosis (physiological tests and imaging modalities), and the major gaps in the management of PAD (eg, medications, exercise therapy, and revascularization). The statement also lists key gaps in research, clinical practice, and implementation related to PAD. Orchestrated efforts among different parties (eg, health care providers, researchers, expert organizations, and health care organizations) will be needed to increase the awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.

show abstract

Section: Awarenessmentioning

confidence: 98%

Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

Criqui¹,

Matsushita²,

Aboyans³

et al. 2021

Circulation

Self Cite

419

234

View full text Add to dashboard Cite

show abstract

“…A further effort should be aimed at improving awareness of PAD among both clinicians and patients. 37 …”

Section: Peripheral Artery Disease In Chronic Kidney Diseasementioning

confidence: 99%

The Impact of Chronic Kidney Disease on Peripheral Artery Disease and Peripheral Revascularization

Serra¹,

Bracale²,

Ielapi³

et al. 2021

IJGM

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Chronic kidney disease (CKD) is a clinical condition characterized by high morbidity and mortality. Globally, CKD is also increasing in prevalence and incidence. The two principal kidney measures namely estimated glomerular filtration rate (eGFR) and albuminuria have been found to be predictors of renal and cardiovascular (CV) endpoints including peripheral artery disease (PAD). The prevalence of PAD was increased in CKD patients and, particularly, in patients with more severe CKD stages. Despite the fact that revascularization strategies are suitable in CKD patients in similar fashion to non-CKD patients, few CKD patients underwent these procedures. In fact, if it is true that revascularization improves prognosis in PAD patients irrespective of baseline eGFR, it was also demonstrated that CKD patients, who underwent revascularization, were at higher risk for amputations, mortality, re-intervention and perioperative complications. With the present review article, we have examined the association between CKD, PAD and peripheral revascularization highlighting data about epidemiology, pathophysiologic mechanisms, and results from previous observational and intervention studies. We have also examined the future perspectives and challenges of research around the association between CKD and PAD.

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“…The present study underscores the notion that chronic kidney disease patients generally demonstrate a premature aging phenotype because even children on dialysis may develop accelerated vascular calcification with arterial stiffening, and young renal failure patients can suffer from a cardiovascular mortality to a similar extent to very old subjects of the general population [ 9 ]. In accordance, clinically relevant peripheral artery disease was also shown to be increased in chronic kidney disease patients later in adulthood [ 10 , 11 ].…”

mentioning

confidence: 77%

Cardiovascular changes in young renal failure patients

Tøndel

Marti

2021

Clinical Kidney Journal

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Progresses in medical care of severe kidney disease and congenital anomalies of kidney and urinary tract make it possible for a higher percentage of young renal failure patients to survive and enter adulthood. There is thus an increasing need to focus on the long term effects of severely reduced kidney function early in life. Cardiovascular changes are known to contribute considerably in adulthood to the severe complications of renal failure. In young chronic kidney disease patients there is limited knowledge of subclinical cardiovascular disease. In this issue of Clinical Kidney Journal, Lalayiannis and collegues describe significant structural and functional cardiovascular changes in a young cohort of kidney failure patients with glomerular filtration rate < 30 ml/min/1.73 m2. Among the hundred patients between 5 and 30 years of age included in the study, eighty-four presented with signs of cardiovascular disease. There is a need of long term follow-up data on cardiovascular consequences of renal failure early in life and evaluation of prophylactic and therapeutic measures that can ameliorate the overall prognosis for these patients. We look forward to planned future long term data of this cohort as well as increased focus in general on cardiovascular changes in young renal failure patients.

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Peripheral Artery Disease in CKD: Anatomically Peripheral But Clinically Central

Cited by 4 publications

References 22 publications

Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

The Impact of Chronic Kidney Disease on Peripheral Artery Disease and Peripheral Revascularization

Cardiovascular changes in young renal failure patients

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