Abstract
The number of high-age patients with end-stage renal disease who require maintenance hemodialysis continues to increase. The incidence of critical limb ischemia among these patients is high because these patients have multiple risk factors for atherosclerosis. Poly-vascular disease, frailty, high bleeding risk, immune-insufficiency, and delayed wound-healing are characteristics of these patients, and these may limit the therapeutic approaches. As the activities of daily life（ADL）of each patient vary widely, the therapeutic goal setting in each case also varies. Prolonged hospitalization for excessive limb salvage, regardless of baseline ADL, may result in a significant deterioration in ADL. A multidisciplinary approach with allied health professionals, including physical therapists or medical social workers, is necessary to improve the outcome for each patient.
