Article Text

other Versions

PDF
Chronic kidney injury in patients after cardiac catheterisation or percutaneous coronary intervention: a comparison of radial and femoral approaches (from the British Columbia Cardiac and Renal Registries)
  1. Tycho Vuurmans1,
  2. Jonathan Byrne2,
  3. Eric Fretz1,
  4. Christian Janssen3,
  5. J David Hilton1,
  6. W Peter Klinke1,
  7. Ognjenka Djurdjev4,
  8. Adeera Levin4
  1. 1Division of Interventional Cardiology, Royal Jubilee Hospital, Victoria, British Columbia, Canada
  2. 2King's College Hospital, London, UK
  3. 3University of Alberta, Alberta, Canada
  4. 4Division of Nephrology, University of British Columbia, Vancouver British Columbia, Canada
  1. Correspondence to Dr Tycho Vuurmans, Victoria Heart Institute, 200-1900 Richmond Avenue, V8R 4R2 Victoria, British Columbia, Canada; tvuurmans{at}vhif.org

Abstract

Background Acute kidney injury (AKI) is a well-recognised complication of cardiac catheterisation and percutaneous coronary intervention (PCI). However, the incidence of chronic kidney disease (CKD) after catheterisation and PCI has not been fully evaluated. A number of risk factors have been implicated in the development of AKI following cardiac catheterisation. Transradial access could lead to a lower incidence of CKD after catheterisation or PCI because of less catheter contact with aortic atheroma, and reduced potential for atheroembolism.

Objective To determine the incidence of CKD onset and its association with arterial access in patients after cardiac catheterisation or PCI.

Methods and results Linkages between the British Columbia (BC) Cardiac Registry (N=69 214) patients who underwent catheterisation or PCI between 1999 and 2005 and the BC Renal Database were determined. Within 6 months after the cardiac procedure 0.4% of patients developed dialysis dependency, 0.2% in the transradial versus 0.4% in the transfemoral group (p<0.0001); 0.3% of patients developed stage 4 or 5 CKD, 0.1% in the transradial versus 0.4% in the transfemoral group (p<0.0001); 0.9% of patients developed new CKD, 0.2% in the transradial versus 1.2% in the transfemoral group (p<0.0001). After adjusting for baseline characteristics the femoral access site had an OR of 4.36 (95% CI 2.48 to 7.66) for the development of the composite end point of new dialysis, new stage 4 or 5 CKD or new CKD.

Conclusions In this large database of current practice coronary catheterisation and PCI, the incidence of CKD onset within 6 months of the procedure was 0.9%. The transradial access site is associated with less CKD than the femoral approach.

Statistics from Altmetric.com

Footnotes

  • Funding Victoria Heart Institute.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of British Columbia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.