Comparison of incidence of acute kidney injury following percutaneous coronary intervention between transradial and transfemoral approaches

Mithun Saha; Mir Jamal Uddin; Abdul Momen; Antara Dey; Gokul Chandra Datta; Badal Chandra Barman; Deb Dulal Debnath

doi:10.18203/2320-6012.ijrms20251275

Authors

Mithun Saha Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Mir Jamal Uddin Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Abdul Momen Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Antara Dey Directorate General of Health Services (DGHS), Dhaka, Bangladesh
Gokul Chandra Datta Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Badal Chandra Barman Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Deb Dulal Debnath Department of Cardiology, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251275

Keywords:

Acute kidney injury, Percutaneous coronary intervention, TFA, Transfemoral approaches, Transradial route

Abstract

Background: Acute kidney injury (AKI) is a significant complication in percutaneous coronary intervention (PCI) patients. Periprocedural bleeding and vascular access site complications are emerging risk factors for post-PCI AKI. Recent studies suggest that transradial PCI has a lower incidence of AKI compared to transfemoral PCI, attributed to reduced vascular and bleeding complications. This study aimed to compare the incidence of acute kidney injury following PCI between transradial and transfemoral approaches.

Methods: This cross-sectional study included 200 ischemic heart disease patients who underwent percutaneous coronary intervention (PCI) via transradial access (TRA, n=98) or transfemoral access (TFA, n=102) from June 2018 to May 2019 at the National Institute of Cardiovascular Diseases (NICVD) Hospital, Dhaka, Bangladesh. Samples were selected purposively, and AKI incidence was assessed post-procedure through serum creatinine levels and urine output. Data analysis was performed using SPSS version 23.0.

Results: Demographic and risk factor variables were similar in both groups. Compared to transfemoral approaches (TFA), transradial approaches (TRA) resulted in significantly fewer major bleeding events (0% vs. 4%, p=0.04) and vascular access site complications (p=0.04). TRA was also associated with a lower incidence of AKI post-PCI (2% vs. 8.8%, p=0.03). Multivariate logistic regression identified transfemoral access as the strongest predictor of AKI after PCI (p=0.001).

Conclusions: The transradial approach is associated with a lower incidence of acute kidney injury (AKI) following percutaneous coronary intervention (PCI) compared to the femoral approach.

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