Factors That Influence Thrombus Formation in Early Catheter Dysfunction and Success of Alteplase Therapy in Children with Hemodialysis
| Autor: | Raden Suhartono, Partini P. Trihono, Alexander Jayadi Utama |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment 0206 medical engineering 02 engineering and technology medicine.disease 020601 biomedical engineering 030218 nuclear medicine & medical imaging 03 medical and health sciences Catheter 0302 clinical medicine Internal medicine medicine Cardiology Hemodialysis Thrombus business |
| Zdroj: | Journal of Indonesian Society for Vascular and Endovascular Surgery. 1:16-20 |
| ISSN: | 2715-1239 2715-1204 |
| Popis: | Introduction: The vascular access modality that is often used to perform regular hemodialysis (HD) measures in children with kidney failure is a tunneled double lumen catheter (TDLC), which has increased its use from 60% in 2011 to 78% in 2014 in Indonesia. The incidence of blockage caused by thrombosis is around 50%. These conditions can occur within the first 24 hours after TDLC, and usually develop within two weeks, causing early catheter dysfunction. Alteplase (rt-PA) is a thrombolytic choice for TDLC dysfunction and heparin, streptokinase, and urokinase. This study aims to determine the factors of thrombus formation in early catheter dysfunction and the effectiveness of alteplase as a therapeutic modality. Method: This study was a case-control study with children aged 0-18 years and suffering from stage 4-5 chronic kidney disease (CKD) who underwent regular HD at Cipto Mangunkusumo National Hospital. Statistical analysis using Mann-Whitney, Chi-square, Fisher’s exact, linear regression, and receiver operating characteristic (ROC) statistical tests. The test was carried out using SPSS version 20 for Windows software. Results: During the period of January 2016 to November 2017, 111 subjects met the criteria. A total of 65 subjects (58.6%) were male, and 46 subjects (41.1%) were female. Analysis showed that each albumin level 5 mg/dL were risk factors for early catheter dysfunction that improved with rt- PA (p5 mg/dL were risk factors for early catheter dysfunction. Alteplase may be useful as a safe therapeutic option. Keywords: tunneled double lumen catheter in children, early catheter dysfunction, rt-PA |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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