【Abstract】Objective To investigate the prevalence of peripheral arterial disease (PAD) in lower extremities and the condition of calcium/phosphorus metabolism among patients undergoing maintenance hemodialysis (MHD), and to further elucidate the impact of calcium/phosphorus metabolism disturbances on PAD in these patients Methods For the diagnosis of PAD in HMD patients, we used color Doppler ultrasonography technique to examine the arterial intima, lumen diameter, plaque, peak of systolic velocity, end diastolic velocity, mean velocity, pulse index and resistant index in arteries of lower extremities and carotid arteries in 73 MHD patients and 60 healthy individuals. The prevalence of PAD and its risk factors were then studied in association with their clinical history and biochemical parameters. Results Based on Doppler ultrasonography, PAD were found in 50.68% (37 cases) MHD patients, in whom PAD was located in one lower extremity in 12 cases and in two lower extremities in 25 cases. PAD was found in 11.67% healthy controls (P＜0.001, as compared with that in HMD patients). Univariate logistic regression analysis showed that PAD in lower extremities in MHD patients was closely associated with serum phosphorus, calcium-phosphorus product, C reactive protein, calcification in carotid arteries, and serum lipoprotein A, albumin and parathyroid hormone. Multivariate logistic regression analysis demonstrated that serum albumin, parathyroid hormone and lipoprotein A levels were independent risk factors causing PAD in lower extremities in HMD patients. Conclusion PAD in lower extremities is frequently encountered among MHD patients. PAD is closely related to calcium/phosphorus metabolic disturbances, micro-inflammation and malnutrition of the patients.