Peripheral Artery Disease and Kidney Disease: Is There a Connection?

Is There a Connection Between PAD and Kidney Disease?

Yes. Research shows the relationship runs in both directions.¹ People with chronic kidney disease (CKD) are more likely to develop PAD than people with normal kidney function, and the risk increases as kidney function drops. At the same time, having PAD appears to independently raise the risk of declining kidney function over time.² Doctors describe this as a cyclical relationship: each condition can make the other more likely, and together they raise the risk of serious complications such as heart attack, stroke, and slow-healing wounds.

Why Kidney Disease and PAD Often Occur Together

Shared Risk Factors

PAD and kidney disease share many of the same risk factors, which helps explain why they so often appear together. These include age, smoking, diabetes, high blood pressure, and high cholesterol. Anyone managing one of these risk factors already has a head start on protecting both their kidneys and their circulation.

How Reduced Kidney Function Raises PAD Risk

Kidney disease appears to add its own risk on top of the common factors above. Reduced kidney function is associated with chronic inflammation and changes in the blood that may encourage plaque to build up faster in the arteries.¹ As kidney function (measured by eGFR) declines, PAD risk tends to rise along with it, even after accounting for diabetes and other shared factors.

Does Kidney Disease Affect Circulation in the Legs?

Kidney disease itself does not directly control blood flow to your legs, but it can accelerate the same artery-narrowing process that causes PAD. As plaque builds up in leg arteries, less oxygen-rich blood reaches your leg muscles and skin. This can lead to symptoms like cramping when you walk, cold feet, or wounds that heal slowly. If you already have kidney disease and notice these changes, it is worth learning more about what PAD is and how it develops, since the two conditions frequently overlap.

We know reading about your risk factors can feel like a lot to take in. If any of this sounds familiar, a short conversation with a vascular specialist can help sort out what is actually going on with your circulation, and what, if anything, you need to do next.

How Doctors Check for PAD When Kidney Disease Is Present

Diagnosing PAD in someone with kidney disease can be trickier than usual. The standard ankle-brachial index (ABI) test, which compares blood pressure at the ankle and the arm, can sometimes read falsely normal in people with kidney disease because their arteries are stiffer than average. Because of this, a vascular specialist may use additional imaging, such as ultrasound, or other diagnostic tools to get a clearer picture of blood flow before recommending any next steps.

Treatment Considerations for PAD and Kidney Disease

When PAD and kidney disease occur together, treatment decisions may need to account for both conditions at once. PAD treatment options such as angioplasty and stent placement may help improve blood flow in patients with both PAD and CKD, and a vascular specialist can factor in kidney function when planning imaging and treatment. Coordinated care between a vascular specialist and your nephrologist can help make sure both conditions are managed with your full health picture in mind.