Kidney Disease Patients May Need Different Artery Tests
Standard tests for artery disease can be inaccurate in patients with kidney failure, requiring alternative screening methods.
Updated on Oct. 22, 2026 in Diabetes
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Nearly 45% of patients with kidney failure also have peripheral artery disease, which often goes undetected due to testing limitations. Clinicians are now highlighting the need for alternative diagnostic methods to ensure these patients receive appropriate care for their vascular health.
Why it matters
Vascular calcification in patients with kidney failure often makes standard diagnostic tests ineffective, causing many to go undiagnosed. Addressing this diagnostic gap is critical because these patients are frequently excluded from clinical trials for peripheral artery disease treatments.
A systematic review found that 44% of 237 randomized peripheral artery disease trials excluded patients with chronic kidney disease, while only 11% reported baseline kidney function. Separately, the 792-participant STRIDE trial showed semaglutide improved walking distance by 13% over 52 weeks.
The players
Pranav Garimella
A medical expert who discussed the intersection of chronic kidney disease and peripheral artery disease at the 2026 Kidney Week conference.
The details
Vascular calcification in individuals with diabetes and kidney failure prevents the compression of vessels required for standard ankle brachial index testing, leading to falsely normal results. To overcome this, clinicians can use segmental pressures and toe brachial pressures, which are not affected by vessel hardening. Nephrology teams are also encouraged to perform routine foot exams during dialysis visits to identify symptoms that patients with neuropathy or arthritis might otherwise miss.
Timeline
On October 22, 2026, experts discussed diagnostic strategies for kidney patients at Kidney Week in Denver.
Health Landscape
Patients with kidney disease have historically been excluded from most major peripheral artery disease trials, leaving a significant gap in evidence-based care. The recent results from the STRIDE trial mark a shift toward including this population in studies for common vascular conditions.
If you have advanced kidney disease, standard ankle tests may not accurately reflect your vascular health. Consult your primary care physician or nephrologist about using specialized diagnostic tools, such as toe brachial pressures, to assess your peripheral artery health.
The takeaway
Peripheral artery disease is common in patients with kidney failure, but standard diagnostic tests often fail to detect it due to vessel calcification. If you have kidney disease, talk to your doctor about alternative testing methods like toe brachial pressures to ensure any circulation issues are identified.
Further reading
Learn more about the latest developments in Diabetes.
Source note: This article includes information reported by Hcplive.
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Should clinical trials be required to include patients with pre-existing conditions like chronic kidney disease?
