Peripheral vascular disease (PVD) is highly prevalent in patients on the waiting list for kidney transplantation (KT) and after transplantation and is associated with impaired transplant outcomes. Multiple traditional and non-traditional risk factors, as well as uremia- and transplant-related factors, affect two processes that can coexist, atherosclerosis and arteriosclerosis, leading to PVD. Some pathogenic mechanisms, such as inflammation-related endothelial dysfunction, mineral metabolism disorders, lipid alterations, or diabetic status, may contribute to the development and progression of PVD. Early detection of PVD before and after KT, better understanding of the mechanisms of vascular damage, and application of suitable therapeutic approaches could all minimize the impact of PVD on transplant outcomes. This review focuses on the following issues: a) definition, epidemiological data, diagnosis, risk factors and pathogenic mechanisms in KT candidates and recipients; b) adverse clinical consequences and outcomes; and c) classical and new therapeutic approaches Disclosures: The authors declare no conflicts of interest Funding: This study was supported in part by the Spanish Ministry of Economy and Competitiveness (grant PI17/02043) from the Instituto de Salud Carlos III co-funded by the Fondo Europeo de Desarrollo Regional-FEDER (REDinREN, RD16/0009/0006). Author for correspondence: Domingo Hernández Nephrology Department, Carlos Haya Regional University Hospital Avda. Carlos Haya s/n., E-29010 Málaga, Spain Phone: +34 952907411; Fax: +34 951291557 E-mail:domingohernandez@gmail.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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