iScience. 2026 Apr 10;29(5):115681. doi: 10.1016/j.isci.2026.115681. eCollection 2026 May 15.
ABSTRACT
Peripheral artery disease (PAD) and kidney dysfunction frequently coexist, worsening clinical outcomes. This study aimed to clarify the relationship between PAD and kidney dysfunction, including their co-occurrence, impact on outcomes, and potential causal links. Analyzing GBD 2021 data, we identified a global PAD prevalence of 1,326.45 per 100,000, with renal impairment as a primary mortality driver. CDC WONDER data ranked renal disease 8th in PAD-related deaths (AAMR 0.22). In MIMIC-IV (n = 2,133), AKI significantly raised 30-day mortality (21.01% vs. 7.23%; HR = 3.21), while CKD stage 4-5 increased 365-day mortality risk (HR = 2.20). 2H-SXMU clinical cohort (n = 200) showed lower eGFR (74.9 vs. 84.6 mL/min/1.73 m2) associated with increased major adverse limb events. Mendelian randomization confirmed a negative causal effect of PAD on eGFR (OR = 0.997, p = 1.75e-3), with no reverse causation found. These findings demonstrate that PAD contributes to declining renal function, highlighting the need for integrated nephrology vascular care and routine renal monitoring in PAD management.
PMID:42080135 | PMC:PMC13133972 | DOI:10.1016/j.isci.2026.115681