The incidence of acute kidney injury after cardiac catheterization or PCI: A comparison of radial vs. femoral approach

Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

“…Damluji et al showed that although the incidence of CIN was low in the TRA approach compared with the TFA approach (2.5% vs 4.5%; P < 0.001), after adjusting for baseline imbalances, the TFA was no longer associated with an increased risk of CIN. 17 Kolte et al in a retrospective observational study evaluated the development of CIN in patients with ST-segment elevation myocardial infarction undergoing primary PCI at 2 high-volume tertiary care centers and found no statistically significant association between the choice of the vascular access site and the risk of CIN development. 18 In conclusion, our study showed that the incidence rate of CIN in patients undergoing diagnostic or interventional coronary management was lower in those treated via the TRA than in the ones treated via the TFA.…”

“…[13][14][15][16] In contrast, some other reports have not been able to show the superiority of the TRA for the reduction of postprocedural CIN-even in high-volume radial centers. 17,18 Moreover, there is evidence indicating that different populations may have different risk factors for the development of nephropathy. 19 Given the dearth of relevant data in our region, we sought to evaluate the association between the use of the 2 vascular access sites of the TRA and the TFA and the presence of CIN in patients undergoing diagnostic or interventional coronary management.…”

Benefit of radial approach in reducing the incidence of acute kidney injury after percutaneous coronary intervention: A meta-analysis of 22,108 patients

“…Interestingly, the lower risk of AKI with transradial access was independent from the observed reduction in bleeding complications [2]. On the contrary, a recent report from a high volume radial center has failed to confirm previous findings [3]. We therefore performed a systematic revision of the literature and a meta-analysis of the available data to examine the potential effectiveness of transradial, as compared to transfemoral access, in reducing the incidence of AKI after PCI.…”

“…Six studies were excluded because they did not report the incidence of AKI after PCI. The remaining 5 observational studies, cumulatively reporting data from 87,701 patients were included in this review [1][2][3]6,7]. Two studies [2,7] out of 5 provided adjusted outcomes by propensity score matching, which were used to the purpose of quantitative synthesis.…”

Radial vs femoral access for the prevention of acute kidney injury (AKI) after coronary angiography or intervention: A systematic review and meta‐analysis

“…Various mechanisms have been implicated for the nephroprotective potential of the radial over the femoral route, including the reduction of (a) access‐related major bleeding, (b) iatrogenic cholesterol embolization in renal circulation, (c) episodes of hypotension, (d) and contrast medium use (especially for high experienced operators) . Several trials explored the effect of the arterial access on the renal outcomes in different subsets of patients, providing heterogeneous findings . Previous meta‐analyses performed to examine this issue have included only observational and nonrandomized studies, possibly introducing bias and confounders, despite forcing adjustment for baseline variables and risk factors .…”