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

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

medial arterial calcification peripheral artery disease chronic kidney disease upper limb hemodialysis access

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