Diabetes decreases patency of tunneled catheters in hemodialysis patients after first effective thrombolysis with urokinase

Autor: Rafał Ficek, Tomasz Irzyniec, Anna M Faba, Dominika Cholewa, Konrad Kopacz, Dominika Wójtowicz, Sylwia Rotkegel, Joanna Kokoszka, Jerzy Chudek, Beata Domańska
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Catheterization
Central Venous
thrombolysis
medicine.medical_treatment
030232 urology & nephrology
Vascular access
urokinase
030204 cardiovascular system & hematology
lcsh:RC870-923
Critical Care and Intensive Care Medicine
recurrent thrombosis
03 medical and health sciences
0302 clinical medicine
Catheters
Indwelling
Fibrinolytic Agents
Recurrence
Renal Dialysis
Diabetes mellitus
Fibrinolysis
medicine
Central Venous Catheters
Humans
Tunneled catheter
Vascular Patency
Aged
Retrospective Studies
Urokinase
Aged
80 and over
Venous Thrombosis
Permanent catheter
business.industry
Brief Report
General Medicine
Thrombolysis
Middle Aged
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
Thrombosis
Urokinase-Type Plasminogen Activator
Surgery
Treatment Outcome
Diabetes Mellitus
Type 2
Nephrology
Female
Hemodialysis
business
medicine.drug
Zdroj: Renal Failure
Renal Failure, Vol 40, Iss 1, Pp 384-389 (2018)
ISSN: 1525-6049
Popis: Introduction: Fibrinolysis is one of the methods extending the use of vascular access in patients with tunneled venous catheters thrombosis. The aim of this study was to assess one-year maintenance of tunneled catheters patency after first effective thrombolysis with urokinase and identify its predictors. Methods: Retrospective analysis included 85 patients (age 69 ± 13 years) with permanent venous catheter thrombosis treated with urokinase at one center in the period 2010–2016. Urokinase was used (depending on weight) at a dose of 10,000 or 20,000 IU in an 8 h infusion to each catheter line. Assessment of one-year efficacy of fibrinolysis included the time between fibrinolysis and following thrombosis of the same catheter in patients that have previously obtained at least partial blood flow. The analysis included medication, comorbidities, catheter patency time and INR value during first thrombosis episode. Results: There were 62.4% patients with type-2 diabetes and 11.8% with neoplasm. The thrombolysis procedure was effective in 73 patients (85.9%). An analysis of the one-year efficacy of thrombolysis procedure included 73 patients. Among them, 23 experienced next episode of catheter-related thrombosis within a year postprocedure. Diabetes increased the risk for recurrent thrombosis [HR =3.19 (1.09-9.41); p = .03]. Conclusions: Patients with diabetes are at higher risk of recurrent catheter-related thrombosis and therefore may require more aggressive anticoagulation therapy for its prevention.
Databáze: OpenAIRE
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