Renal function impairment in peripheral arterial disease: an important parameter that should not be neglected.

A considerable percentage of patients with peripheral arterial disease (PAD) have impaired renal function. We searched the literature (PubMed/Medline) to determine the clinical significance and assess the management of renal dysfunction in these patients. The results of our literature search suggest that impaired renal function is a frequent finding in patients with PAD. The presence of concomitant renal dysfunction in these patients is associated with higher morbidity and mortality rates, as well as the occurrence of cardiovascular events (stroke, myocardial infarction, and vascular death). Additionally, impaired renal function negatively affects survival, limb salvage, and graft patency rates when these patients undergo lower extremity revascularization procedures. The use of statins and angiotensin-converting enzyme (ACE) inhibitors is associated with improved renal function and reduced cardiovascular risk in patients with PAD. Based on current evidence, renal function should be assessed and regularly monitored in all patients with PAD. More importantly, initiation of appropriate treatment (e.g., statins and ACE inhibitors) should be implemented to preserve renal function and improve vascular morbidity and mortality in these patients.