Vuurmans T
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This study investigates the incidence of chronic kidney disease (CKD) following cardiac catheterization and percutaneous coronary intervention (PCI) using radial versus femoral access sites. Results indicate that transradial access is linked to a lower incidence of CKD and reduced need for dialysis compared to femoral access. Overall, only 0.9% of patients developed CKD within six months post-procedure.
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Vuurmans T
- 1. Chronic kidney injury in patients after cardiac catheterization or percutaneous coronary intervention A comparison of radial and femoral approaches (from the British Columbia Cardiac and Renal Registries) Tycho Vuurmans, M.D., Ph.D. Division of Cardiology, Royal Jubilee Hospital, Victoria, B.C., Canada
- 2. Background Acute kidney injury (AKI) is a common complication of cardiac catheterization and percutaneous coronary intervention (PCI) The incidence of chronic kidney disease (CKD) after catheterization and PCI is unknown Procedural risk factors for AKI include contrast use and renal atheroemboli caused by catheter dislodgement of aortic atheroma Transradial access could lead to a lower incidence of AKI, and thus reduced CKD after catheterization or PCI because of less catheter contact with aortic atheroma, and reduced potential for atheroembolism
- 3. Objective To determine the incidence and progression of chronic kidney disease and its association with arterial access site in unselected catheterization and PCI cases
- 4. Methods Linkages between British Columbia Cardiac Registry (N= 69214 ) patients who underwent catheterization or PCI between 1999 and 2005 and the British Columbia Renal Database (PROMIS) The main outcome measure was incidence or progression of CKD within 6 months after the cardiac procedure defined by new dialysis, new stage 4 or 5 CKD (estimated glomerular filtration rate < 30 ml/min), or new referral to nephrology within 6 months after catheterization or PCI.
- 5. Summary of procedures by access site and entry in BC Provincial Renal Agency database (PROMIS)
- 6. Clinical variables in the whole cohort split by association with access site
- 8. Contrast use for radial and femoral access sites * * * p<0.0001
- 9. Comparison of the radial and femoral access site for PCI or catheterization on renal outcomes
- 10. Binary logistic regression analysis for 6 month adverse renal outcomes for baseline variables
- 11. Conclusion In this large database of current practice coronary catheterization and percutaneous coronary intervention, the incidence of chronic kidney disease within 6 months of the procedure is 0.9% The transradial access site is associated with a lower incidence of CKD, new dialysis and new stage 4 or 5 CKD than the femoral access site The transradial access site is associated with less contrast use than the femoral access site