Hossain Mohammad A, Quinlan Amy, Heck-Kanellidis Jennifer, Calderon Dawn, Patel Tejas, Gandhi Bhavika, Patel Shrinil, Hetavi Mahida, Costanzo Eric J, Cosentino James, Patel Chirag, Dewan Asa, Kuo Yen-Hong, Salman Loay, Vachharajani Tushar J
1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine, Neptune, NJ, USA.
2 Jersey Shore University Medical Center, Neptune, NJ, USA.
J Vasc Access. 2018 Jul;19(4):346-349. doi: 10.1177/1129729817752874. Epub 2018 Mar 12.
While transradial approach to conduct percutaneous coronary interventions offers multiple advantages, the procedure can cause radial artery damage and occlusion. Because radial artery is the preferred site for the creation of an arteriovenous fistula to provide dialysis, patients with chronic kidney disease are particularly dependent on radial artery for their long-term survival.
In this retrospective study, we investigated the prevalence of chronic kidney disease in patients undergoing coronary interventions via radial artery. Stage of chronic kidney disease was based on estimated glomerular filtration rate and National Kidney Foundation - Kidney Disease Outcomes Quality Initiative guidelines.
A total of 497 patients undergoing transradial percutaneous coronary interventions were included. Over 70.4% (350/497) of the patients had chronic kidney disease. Stage II chronic kidney disease was observed in 243 (69%) patients (estimated glomerular filtration rate = 76.0 ± 8.4 mL/min). Stage III was observed in 93 (27%) patients (estimated glomerular filtration rate = 49 ± 7.5 mL/min). Stage IV chronic kidney disease was observed in 5 (1%) patients (estimated glomerular filtration rate = 25.6 ± 4.3 mL/min) and Stage V chronic kidney disease was observed in 9 (3%) patients (estimated glomerular filtration rate = 9.3 ± 3.5 mL/min). Overall, 107 of 350 patients (30%) had advanced chronic kidney disease, that is, stage III-V chronic kidney disease. Importantly, 14 of the 107 (13%) patients had either stage IV or V chronic kidney disease.
This study finds that nearly one-third of the patients undergoing transradial percutaneous coronary interventions have advanced chronic kidney disease. Because many of these patients may require dialysis, the use of radial artery to conduct percutaneous coronary interventions must be carefully considered in chronic kidney disease population.
虽然经桡动脉途径进行经皮冠状动脉介入治疗具有多种优势，但该操作可能导致桡动脉损伤和闭塞。由于桡动脉是建立动静脉内瘘以进行透析的首选部位，慢性肾脏病患者的长期生存特别依赖于桡动脉。
在这项回顾性研究中，我们调查了经桡动脉进行冠状动脉介入治疗患者的慢性肾脏病患病率。慢性肾脏病的分期基于估计肾小球滤过率和美国国立肾脏基金会-肾脏病预后质量倡议指南。
共纳入497例接受经桡动脉经皮冠状动脉介入治疗的患者。超过70.4%（350/497）的患者患有慢性肾脏病。243例（69%）患者为Ⅱ期慢性肾脏病（估计肾小球滤过率=76.0±8.4ml/min）。93例（27%）患者为Ⅲ期（估计肾小球滤过率=49±7.5ml/min）。5例（1%）患者为Ⅳ期慢性肾脏病（估计肾小球滤过率=25.6±4.3ml/min），9例（3%）患者为Ⅴ期慢性肾脏病（估计肾小球滤过率=9.3±3.5ml/min）。总体而言，350例患者中有107例（30%）患有晚期慢性肾脏病，即Ⅲ-Ⅴ期慢性肾脏病。重要的是，107例患者中有14例（13%）为Ⅳ期或Ⅴ期慢性肾脏病。
本研究发现，近三分之一接受经桡动脉经皮冠状动脉介入治疗的患者患有晚期慢性肾脏病。由于这些患者中的许多人可能需要透析，因此在慢性肾脏病患者中使用桡动脉进行经皮冠状动脉介入治疗必须谨慎考虑。
