Peripheral arterial disease in hemodialysis access

Renal failure is a significant risk factor for developing peripheral artery disease. Hemodialysis is the major form of renal replacement therapy in the United States. The success of maintaining sufficient blood flow through a hemodialysis access circuit is dependent on many factors including a robust arterial inflow. Failure to mature, insufficient blood flow, frequent thrombosis and steal syndrome are consequences of peripheral artery disease impairing the arterial inflow of a dialysis access circuit. Careful pre-procedure evaluation, endovascular interventions such as balloon angioplasty/stent placement and surgery can prevent and/or treat early access failure and ischemic complications related to peripheral arterial disease.