[Transradial approach and kidney disease]

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Interventional Cardiology

Context:

• Patients with chronic kidney disease (CKD) face elevated cardiovascular risks.
• Aging populations and diabetes increase CKD prevalence and associated mortality.
• Transradial approach is often avoided in CKD patients due to concerns about radial artery suitability for future arteriovenous fistulas.

Purpose:

• To evaluate the safety and efficacy of the transradial approach in patients with chronic kidney disease.
• To compare the risks of vascular complications between transradial and transfemoral access in CKD patients.
• To determine if the transradial approach can be safely utilized in CKD patients, even those on hemodialysis.

Summary:

• The transradial approach, despite traditional contraindications in chronic kidney disease (CKD) patients, may offer significant benefits.
• It dramatically reduces vascular bleeding complications compared to transfemoral access, leading to fewer adverse events and lower mortality, particularly in high-risk CKD subgroups.
• The risk of vascular complications from transfemoral access may outweigh the concern of potential radial artery injury for future arteriovenous fistula creation in CKD patients.

Impact:

• The transradial approach could be a viable option for CKD patients, improving procedural safety and outcomes.
• This approach may reduce overall mortality in high-risk CKD patients undergoing vascular procedures.
• Further large-scale randomized trials are essential to definitively compare radial and femoral access strategies in the CKD population.