Efficacy of Urokinase Containing Locking Solutions for Thrombotic Dysfunction of Tunneled Hemodialysis Catheters

Universitair Ziekenhuis Brussel148 enrolled

Overview

Thrombotic dysfunction is a common complication of tunneled cuffed catheters (TCC) leading to inadequate dialysis dose, need to catheter replacement with as consequence progressive exclusion of vascular sites. Thrombolytic agent can be used as therapeutic locking solution to dissolve the clotting formed in of around the catheter lumen. There are few studies on the optimal approach of TCC-related thrombosis with thrombolytic containing locking solution (dose, number of administrations, timing of administration - intra or interdialytic use). The primary objective of this retrospective study was to compare the efficacy of inter versus intradialytic Urokinase containing locking solution on restoration of the TCC blood flow. The investigators also assess the question of multiple administrations of Urokinase are more efficient than one single administration

Study Type

OBSERVATIONAL

Enrollment

148

Conditions

Kidney Failure, Chronic Vascular Access Devices

Interventions

Urokinase locking solution

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Hemodialysis patients over 18 years old, receiving hemodialysis between 1st May 2010 and 31st October 2014 via a tunneled cuffed catheter at the Hemodialysis Unit of Universitair Ziekenhuis Brussel Hospital. Exclusion Criteria: * Patients younger than 18 years old * Patients with a temporary dialysis catheter * Patients who never received a tunneled hemodialysis catheter in this period * Patients who didn't have a medical file at the Universitair Ziekenhuis Brussel Hospital

Outcomes

Primary Outcomes

Change in catheter blood flow (expressed in ml/min) after Urokinase-containing locking solution

Comparison of catheter blood flow measurement before and after Urokinase locking solution administration according to the type of Urokinase prescription (inter- versus intra-dialytic use, one- single versus multiple administrations)

Time frame: up to 54 months

Change of pump pressures (expressed in mmHg) after Urokinase-containing locking solution

Comparison of pump pressures measurement before and after Urokinase locking solution administration according to the type of prescription of Urokinase containing locking solution (inter versus intra-dialytic, one single use versus multiple administrations)