REVIEWLower-Extremity Peripheral Arterial Disease among Patients with End-Stage Renal DiseaseO’Hare, Ann*; Johansen, Kirsten*†‡ Author Information Departments of *Medicine and †Biostatistics and Epidemiology, University of California, San Francisco, California; and ‡Department of Medicine, Veterans Affairs Medical Center, San Francisco, California. Correspondence to Dr. Ann O’Hare, 4150 Clement St., San Francisco, CA 94121. Phone: 415-221-4810 (ext. 4953); Fax: 415-750-6949; E-mail: [email protected] Accepted March 29, 2001 Received February 05, 2001 Journal of the American Society of Nephrology 12(12):p 2838-2847, December 2001. | DOI: 10.1681/ASN.V12122838 Buy Metrics Abstract ABSTRACT. Peripheral arterial occlusive disease (PAOD) accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients but has not been as extensively studied as other kinds of atherosclerotic disease in this population. The current epidemiology and management of PAOD in ESRD patients is here reviewed and target areas for future research are identified. The prevalence of PAOD appears to be much higher among ESRD patients than in the general population. Risk factors for disease among ESRD patients are not well understood but probably include both conventional and dialysis or uremia-associated risk factors. Standard diagnostic techniques used to identify PAOD in the general population may not be as helpful in ESRD patients because many of these tests are inaccurate in the settings of vascular calcification and small-vessel disease. Despite the fact that this is a common disease in ESRD patients, most of these patients are not screened for PAOD. Interventions that have proven effective in the prevention and treatment of PAOD in the general population, such as smoking cessation, preventive foot care, and exercise, have not been systematically applied to ESRD patients. Furthermore, the optimal management of ischemic ulceration and gangrene in ESRD patients is quite controversial, and better algorithms for the prevention and management of PAOD in ESRD patients are needed. In conclusion, PAOD is common in ESRD patients. Future research should identify risk factors for disease in this population, and efforts should be made to develop strategies for the effective prevention and management of limb ischemia in this population. Copyright © 2001 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.