Subclinical peripheral arterial disease in renal transplantation

BACKGROUND:: Peripheral arterial disease (PAD) is a common finding in patients at various stages of chronic kidney disease; however, there has only been a limited amount of data that have been published regarding the prevalence and associated risk factors of subclinical PAD in renal transplant recipients. METHODS:: The authors cross sectionally investigated the prevalence of PAD using ankle-brachial index (ABI) in 304 renal transplant recipients with no previous diagnosis of PAD. Patients were considered to have subclinical PAD when ABI <0.9. The authors also determined the associated risk factors for subclinical PAD. RESULTS:: The mean age of the 304 patients was 53 years, and 30 patients (9.9%) had a history of atherosclerotic event (including past cardiovascular and cerebrovascular events). Twenty-five of the 304 patients (8%) had ABI <0.9 and 1 had (0.3%) ABI >1.3. Compared to patients with normal ABI, a history of atherosclerotic events is the only independent risk factor for patients with subclinical PAD (P = 0.0468). CONCLUSIONS:: Subclinical PAD is an inadvertent issue in renal transplant patients, especially those with a history of atherosclerotic events. Further research is needed on the long-term clinical impact and optimal treatment of subclinical PAD among renal transplant patients.