Chronic kidney disease (CKD) in patients with symptomatic peripheral artery disease (PAD) increases their risk of cardiovascular events, new study findings suggest.

In a study of 13,483 patients with symptomatic PAD, patients with CKD had a higher rate of a composite end point of cardiovascular death, myocardial infarction, or ischemic stroke than those without CKD (6.75 vs 3.72 events per 100 patient-years) after statistical adjustment, Charles W. Hopley, MD, of Dartmouth Hitchcock Medical Center in Hanover, New Hampshire, and colleagues reported in Vascular Medicine. CKD was associated with a significant 45% increased risk of the composite end point in an adjusted analysis.

The investigators defined CKD as an estimated glomerular filtration rate below 60 mL/min/1.73 m2.

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The study found no association between CKD and risk of hospitalization for acute limb ischemia or major amputation. Although CKD was not associated with an increased risk for major bleeding, it was associated with a significant 51% increased risk of minor bleeding. Study patients were participants in the EUCLID (Examining Use of Ticagrelor in PAD) trial. Of the 13,483 patients, 3332 (25%) had CKD, including 237 with stage 4 or 5 disease. Patients had a median follow-up of about 30 months.


Hopley CW, Kavanagh S, Patel MR, et al. Chronic kidney disease and risk for cardiovascular and limb outcomes in patients with symptomatic peripheral artery disease: The EUCLID trial. Vasc Med. 2019. doi: 10.1177/1358863X19864172