At three years, freedom from restenosis declined to 61.9% in hemodialysis patients and 66.3% in those not on dialysis. In the hemodialysis group, restenosis was observed in 363 lesions during a median follow-up of 16.2 months. Despite the higher restenosis rates, over 90% of hemodialysis patients achieved limb salvage within three years. The high limb preservation rate supports the role of DCB therapy as an effective option, even in complex hemodialysis patients. Hemodialysis patients were generally younger (average age 72 years) compared to non-dialysis patients (76 years).