CONDITIONS WE TREAT
Chronic Kidney Disease (CKD)
Chronic kidney disease and cardiovascular disease travel together — they share the same drivers and each one worsens the other. We work alongside your nephrologist on the vascular side of CKD: protecting circulation, lowering cardiovascular risk, and planning ahead for access if kidney function declines.
What it is
Chronic kidney disease means the kidneys have been gradually losing their ability to filter the blood, usually over years. It is often silent in its early stages and is most commonly driven by diabetes and high blood pressure — the very same conditions that drive peripheral artery disease and heart disease. That overlap is why CKD rarely travels alone, and why the heart and arteries deserve attention at every stage.
Why it matters
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Cardiovascular risk is the headline. For most people with CKD, heart and vascular disease — not kidney failure — is the greater day-to-day threat. Aggressive risk-factor control protects both.
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It accelerates artery disease. CKD speeds up atherosclerosis and arterial calcification, raising the risk of peripheral artery disease, coronary disease, and limb-threatening ischemia.
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Sometimes the kidneys are the clue, not the cause. Resistant high blood pressure or a sudden drop in kidney function can point to renal artery stenosis — a narrowing we can evaluate and, when appropriate, treat.
Risk Factors
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Diabetes and high blood pressure — together they account for most CKD, and they are the same two drivers behind peripheral artery disease
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Cardiovascular disease; heart failure
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Family history of kidney disease; older age
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Recurrent injury from contrast dye, NSAIDs, or repeated episodes of acute kidney injury
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Obesity, smoking, and untreated obstructive sleep apnea
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Renal artery stenosis, which can be a cause rather than a consequence →
Diagnostic Testing
Kidney function is your nephrologist’s territory, and we do not duplicate it. What we test for is the vascular disease CKD makes more likely, and the treatable vascular causes that sometimes sit behind it.
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eGFR and urine albumin — the two numbers that stage CKD, tracked with your nephrologist.
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Renal artery duplex ultrasound, with no contrast, when a narrowed kidney artery is suspected →.
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Arterial duplex of the legs, because CKD accelerates PAD and blunts the ankle-brachial index that would otherwise detect it →.
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Vein mapping when dialysis access will be needed.
Treatment options
Medical & conservative therapy
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Statin and antiplatelet therapy; blood-pressure and diabetes control, coordinated with your nephrologist and primary care physician.
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Tobacco cessation →.
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Avoiding avoidable contrast, NSAIDs, and nephrotoxic exposures.
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Screening for the artery disease CKD makes more likely, before it declares itself as a wound.
Invasive treatment
Where we fit in your kidney care
We are a cardiovascular and vascular practice, not a substitute for your nephrologist — we partner with them. Our role is the circulation side of CKD:
Cardiovascular risk reduction
Statin and antiplatelet therapy, blood-pressure and diabetes coordination, and screening for the artery disease CKD makes more likely.
Renovascular evaluation
When a narrowed kidney artery may be driving resistant hypertension or declining function, we assess it and treat when it's likely to help. Renal artery intervention
Dialysis access planning
If kidney function progresses toward failure, planning access early protects future dialysis. A surgeon creates the fistula or graft; our role is keeping it working, and an access problem is seen the same day if possible or within two business days, based on your availability. Dialysis access
Protecting your kidneys during procedures
Contrast dye can stress kidneys that are already vulnerable, so kidney protection is built into how we perform limb-salvage and vascular work — not added as an afterthought.
We use intravascular ultrasound (IVUS) to guide treatment with minimal dye, an ultra-low-contrast technique, and — for patients on dialysis or with advanced (stage 5) CKD — CO₂ angiography, which uses carbon-dioxide gas in place of iodinated contrast so a procedure can be done with little or no dye at all. We coordinate the plan with your nephrologist.
When to be evaluated — or refer
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CKD with leg pain when walking, a non-healing foot wound, or other signs of PAD.
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Resistant high blood pressure or a sudden rise in creatinine, especially after starting an ACE inhibitor or ARB — possible renal artery stenosis
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Advancing CKD (declining eGFR) where it's time to plan dialysis access before it's urgent.
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Known CKD with diabetes — a high-risk combination for both the heart and the legs.
Frequently asked questions
For referring providers — We welcome referrals from nephrology and primary care for CKD patients with cardiovascular or peripheral artery disease, suspected renovascular hypertension, or upcoming dialysis access planning. Refer: (918) 943-5303 · fax (855) 312-3594.
When to refer: advanced-CKD patients who need angiography or intervention — for contrast-minimization planning (CO₂, IVUS, ultra-low-contrast) Full referral guide →