Screening For This Under-Diagnosed Disease Found In CKD Patients Could Save Legs And Lives

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In many cases, those with Chronic Kidney Disease (CKD) have normalized leg pain and uncomfortable tingling in legs, calves and feet as simply another side effect of kidney failure. Frequent leg cramps, leg pain when walking and slow-to-heal sores on your feet are annoying, but did you know they can also be symptoms of a serious disease called Peripheral Artery Disease (PAD)? PAD occurs when there is narrowing of the blood vessels (arteries) outside of the heart. Studies indicate that PAD is much more common in patients with CKD (especially those in later stages) than the general population. Although the risk of mortality is increased in those with CKD, few patients are given treatment for this condition.

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Most frequently PAD affects the arteries in the pelvis and legs, but it can also affect the arteries in the arms, stomach, aorta (a major blood vessel that comes from the heart and supplies blood to the rest of the body). PAD in the legs occurs when the leg arteries become clogged with fatty deposits that can reduce blood flow to the legs and feet and in severe cases, if left untreated, amputation may be necessary.

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PAD can also be a red flag that the same fatty deposit build-up is happening in blood vessels elsewhere in your body, putting you at a four to five times greater risk for having a heart attack or stroke. PAD affects a significant percentage of Americans yet only a minority of them have any symptoms, according to the American Heart Association. Even those who do experience PAD symptoms often fail to mention them to their doctor, so it is left untreated.

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Specific symptoms of PAD can include: leg pain when walking, foot or toe pain that disturbs sleep, a decrease in body temperature in the lower leg or foot, sores on legs or feet that are slow to heal, a change in the skin color of the legs or feet and slower hair and toenail growth. encourages CKD patients who are experiencing these symptoms to discuss the matter immediately with their Nephrologist and ask to be screened for PAD.

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While PAD can become a very serious condition if left untreated, it also can be successfully treated through a number of methods. Many CKD patients can prevent serious issues by simply increasing their exercise and adopting a low fat diet. Some patients may need to take blood pressure or cholesterol-lowering medications, or blood thinners. For stubborn blockages, a balloon catheter may be inserted through a small incision in an artery to the location of the blockage and inflated to open the vessel. A tiny metal tube (stent) may also be used to hold the artery open.

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“It is important for patients to discuss any peripheral artery disease symptoms they may be having with their health care provider,” says Dr. Charles A. Simonton, Chief Medical Officer for Vascular Devices at Abbott. One of the most common tests for PAD is called Ankle-Brachial Index (ABI), a simple non-invasive test that can be done in your Nephrologist's office. In a typical ABI test, the physician uses a blood pressure cuff to measure the blood pressure in both arms and ankles at rest and then again after exercise. Changes in blood pressure between rest and exercise can determine if a you have the disease.

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People with CKD often think that their chronic leg pain is due to arthritis, aging or just another part of their condition so their PAD goes undiagnosed. The earlier you can identify PAD, the better chance you have of restoring blood flow in your legs, avoiding more serious problems. If you think you could be at risk of this disorder, strongly recommends speaking with your Nephrologist about the issue promptly.

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