Upper Extremity Medial Arterial Calcification and Peripheral Artery Disease in Asymptomatic Patients With Chronic Kidney Disease in Predialysis Stage

Angiology. 2018 May;69(5):406-415. doi: 10.1177/0003319717725966. Epub 2017 Aug 21.

Abstract

Two types of peripheral artery disease (PAD) in asymptomatic patients with chronic kidney disease (CKD) can be detected by the use of duplex Doppler: medial arterial calcification (MAC) and occlusive PAD. The aim of this pilot study is to evaluate different types of subclinical PAD in upper extremities of patients with CKD. The prevalence of upper extremity MAC and occlusive PAD was investigated in 41 asymptomatic patients with CKD and 18 controls with normal kidney function, using duplex Doppler ultrasound, according to the vascular laboratory protocol. A mild-to-severe MAC was significantly more prevalent in patients with CKD compared to the control group ( P = .015), mostly in radial arteries (RAs; P = .002 and P = .016, respectively). The prevalence of occlusive PAD was not significantly different between the 2 groups ( P = .381). Patients in the CKD group were younger, nonsmokers, and more often had hypertension ( P = .038, P = .038, and P = .034, respectively). A duplex ultrasound screening for upper extremity subclinical PAD in patients with CKD in a predialysis stage may identify patients with mild-to-severe MAC which is important in surgery of hemodialysis access.

Keywords: chronic kidney disease; hemodialysis access; medial arterial calcification; peripheral artery disease; upper limb.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Humans
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / epidemiology*
  • Pilot Projects
  • Prevalence
  • Renal Dialysis
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / therapy
  • Upper Extremity / blood supply*
  • Vascular Calcification / diagnosis
  • Vascular Calcification / epidemiology*