Association of Access to the Radial Artery with Reduced Incidence of Acute Kidney Injury: Association of Access to the Radial Artery

Sanjay Gandhi; Haris Khan; Umer Bin Tariq; Gulfan Ullah; Akmal Zubair

doi:10.54393/pjhs.v4i10.1100

Authors

Sanjay Gandhi Department of Cardiology, DHQ Buner, Pakistan
Haris Khan Rehman Medical College, Peshawar, Pakistan
Umer Bin Tariq Department of Medicine, Nawaz Sharif Medical College, Gujrat, Pakistan
Gulfan Ullah Department of Botany, Faculty of Biological Science, Kohat University of Science and Technology, Kohat, Pakistan
Akmal Zubair Department of Biotechnology, Quaid e Azam University, Islamabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i10.1100

Keywords:

Radial Artery, Acute Kidney Injury (AKI), Patient-Centric, Interventional procedures

Abstract

The research looks at access to the radial artery in contemporary medicine to lower the occurrence of acute kidney injury (AKI). In an effort to increase patient-centered procedural safety, it evaluates evidence contrasting radial versus femoral access. Objective: To determine if access to the radial artery and the prevalence of AKI during interventional procedures, with an emphasis on evaluating the possible advantages of radial access in lowering the risk of AKI. Methods: An examination of 132 instances classified by access location (radial artery as opposed to other sites) was done retrospectively. Beginning in September 2022 and ending in March 2023, the study's length was six months. AKI incidence, procedure specifics, and demographic data were compared. The independent influence of radial access on the risk of AKI was evaluated using multivariate logistic regression. Results: The radial artery group (13.6%) exhibited a significantly lower AKI incidence than the comparator group (27.3%). Multivariate analysis confirmed the independent association. Conclusions: The possible relevance of access to the radial artery in reducing post-procedural AKI highlights the possibility of a safer alternative. Evidence-based access site selection is becoming more crucial in the age of patient-centered healthcare to improve procedural outcomes.

References

Sinha SK, Jha MJ, Mishra V, Thakur R, Goel A, Kumar A, et al., Radial artery occlusion–incidence, predictors and long-term outcome after transradial catheterization: clinico-Doppler ultrasound-based study (RAIL-TRAC study). Acta Cardiologica. 2017 May; 72(3): 318-27. doi: 10.1080/00015385.2017.1305158. DOI: https://doi.org/10.1080/00015385.2017.1305158

van Leeuwen MA, Hollander MR, Van Der Heijden DJ, van de Ven PM, Opmeer KH, Taverne YJ, et al., The ACRA Anatomy Study (Assessment of Disability After Coronary Procedures Using Radial Access) A Comprehensive Anatomic and Functional Assessment of the Vasculature of the Hand and Relation to Outcome After Transradial Catheterization. Circulation: Cardiovascular Interventions. 2017 Nov; 10(11): 005753. doi: 10.1161/CIRCINTERVENTIONS.117.005753. DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.117.005753

Lincoff AM, Mehran R, Povsic TJ, Zelenkofske SL, Huang Z, Armstrong PW, et al., Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial. The Lancet. 2016 Jan; 387(10016): 349-56. doi: 10.1016/S0140-6736(15)00515-2. DOI: https://doi.org/10.1016/S0140-6736(15)00515-2

Doll JA, Beaver K, Naranjo D, Waldo SW, Maynard C, Helfrich CD, et al., Trends in arterial access site selection and bleeding outcomes following coronary procedures, 2011–2018. Circulation: Cardiovascular Quality and Outcomes. 2022 May; 15(5): 008359. doi: 10.1161/CIRCOUTCOMES.121.008359. DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.008359

Idris H, French JK, Shugman IM, Hopkins AP, Juergens CP, Thomas L. Influence of age and gender on clinical outcomes following percutaneous coronary intervention for acute coronary syndromes. Heart, Lung and Circulation. 2017 Jun; 26(6): 554-65. doi: 10.1016/j.hlc.2016.10.021. DOI: https://doi.org/10.1016/j.hlc.2016.10.021

Bloom JE, Dinh DT, Noaman S, Martin C, Lim M, Batchelor R, et al., Adverse impact of chronic kidney disease on clinical outcomes following percutaneous coronary intervention. Catheterization and Cardiovascular Interventions. 2021 May; 97(6): 801-9. doi: 10.1002/ccd.29436. DOI: https://doi.org/10.1002/ccd.29436

Aitken E, Jackson A, Kearns R, Steven M, Kinsella J, Clancy M, et al., Effect of regional versus local anaesthesia on outcome after arteriovenous fistula creation: a randomised controlled trial. The Lancet. 2016 Sep; 388(10049): 1067-74. doi: 10.1016/S0140-6736(16)30948-5. DOI: https://doi.org/10.1016/S0140-6736(16)30948-5

Dworeck C, Redfors B, Völz S, Haraldsson I, Angerås O, Råmunddal T, et al., Access to the radial artery is associated with lower mortality in patients undergoing primary PCI: A report from the SWEDEHEART registry. European Heart Journal: Acute Cardiovascular Care. 2020 Jun; 9(4): 323-32. doi: 10.1177/2048872620908032. DOI: https://doi.org/10.1177/2048872620908032

Ishihara T, Yamaji K, Iida O, Kohsaka S, Inohara T, Shinke T, et al., Impact of peripheral artery disease on short-term outcomes after percutaneous coronary intervention: A report from Japanese nationwide registry. PLOS one. 2020 Oct; 15(10): 0240095. doi: 10.1371/journal.pone.0240095. DOI: https://doi.org/10.1371/journal.pone.0240095

Wang C, Chen W, Yu M, Yang P. Comparison of acute kidney injury with radial vs. femoral access for patients undergoing coronary catheterization: An updated meta analysis of 46,816 patients. Experimental and Therapeutic Medicine. 2020 Nov; 20(5): 1-12. doi: 10.3892/etm.2020.9170. DOI: https://doi.org/10.3892/etm.2020.9170

Kumbar L and Yee J. Current concepts in hemodialysis vascular access infections. Advances in Chronic Kidney Disease. 2019 Jan; 26(1): 16-22. doi: 10.1053/j.ackd.2018.10.005. DOI: https://doi.org/10.1053/j.ackd.2018.10.005

Nadim MK, Forni LG, Mehta RL, Connor Jr MJ, Liu KD, Ostermann M, et al., COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nature Reviews Nephrology. 2020 Dec; 16(12): 747-64. doi: 10.1038/s41581-020-00356-5. DOI: https://doi.org/10.1038/s41581-020-00356-5

Salmasi V, Maheshwari K, Yang D, Mascha EJ, Singh A, Sessler DI, et al., Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney and myocardial injury after noncardiac surgery: a retrospective cohort analysis. Anesthesiology. 2017 Jan; 126(1): 47-65. doi: 10.1097/ALN.0000000000001432.. DOI: https://doi.org/10.1097/ALN.0000000000001432

Lachance P, Villeneuve PM, Rewa OG, Wilson FP, Selby NM, Featherstone RM, et al., Association between e-alert implementation for detection of acute kidney injury and outcomes: a systematic review. Nephrology Dialysis Transplantation. 2017 Feb; 32(2): 265-72. doi: 10.1093/ndt/gfw424. DOI: https://doi.org/10.1093/ndt/gfw424

Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al., KDOQI clinical practice guideline for vascular access: 2019 update. American Journal of Kidney Diseases. 2020 Apr; 75(4): 1-64. doi: 10.1053/j.ajkd.2019.12.001. DOI: https://doi.org/10.1053/j.ajkd.2019.12.001

Branch-Elliman W, Ripollone JE, O’Brien WJ, Itani KM, Schweizer ML, Perencevich E, et al., Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: a national propensity-score-adjusted retrospective cohort study. PLOS Medicine. 2017 Jul; 14(7): 1002340. doi: 10.1371/journal.pmed.1002340. DOI: https://doi.org/10.1371/journal.pmed.1002340

Blair M, Côté JM, Cotter A, Lynch B, Redahan L, Murray PT. Nephrotoxicity from vancomycin combined with piperacillin-tazobactam: a comprehensive review. American Journal of Nephrology. 2021 Apr; 52(2): 85-97. doi: 10.1159/000513742. DOI: https://doi.org/10.1159/000513742

Gargiulo G, Giacoppo D, Jolly SS, Cairns J, Le May M, Bernat I, et al., Effects on mortality and major bleeding of radial versus femoral artery access for coronary angiography or percutaneous coronary intervention: meta-analysis of individual patient data from 7 multicenter randomized clinical trials. Circulation. 2022 Nov; 146(18): 1329-43. doi: 10.1161/CIRCULATIONAHA.122.061527. DOI: https://doi.org/10.1161/CIRCULATIONAHA.122.061527

Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging and Disease. 2018 Feb; 9(1): 143-50. doi: 10.14336/AD.2017.0306. DOI: https://doi.org/10.14336/AD.2017.0306

Uddin I, Khan MI, Younas N, Hashmi MO, Shah S, Mehmood A. Association of Access to the radial artery with Reduced Incidence of Acute Kidney Injury. Pakistan Journal of Medical & Health Sciences. 2023 Mar; 17(01): 867-9. doi: 10.53350/pjmhs2023171867. DOI: https://doi.org/10.53350/pjmhs2023171867

Shinwari MI, Khan MI, Hasan T, Khan RM, Ziyad M. Association of Access to the radial artery with Reduced Incidence of Acute Kidney Injury in Patient Undergoing Percutaneous Coronary Intervention. Pakistan Journal of Medical & Health Sciences. 2023 May; 17(2): 820-2-. doi: 10.53350/pjmhs2023172820. DOI: https://doi.org/10.53350/pjmhs2023172820

Andò G, Costa F, Trio O, Oreto G, Valgimigli M. Impact of vascular access on acute kidney injury after percutaneous coronary intervention. Cardiovascular Revascularization Medicine. 2016 Jul; 17(5): 333-8. doi: 10.1016/j.carrev.2016.03.004. DOI: https://doi.org/10.1016/j.carrev.2016.03.004