Efficacy of reteplase in poorly functioning hemodialysis catheters

Abigail Falk, W. Samson, J. Uribarri, J. A. Vassalotti

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Aim: This is a retrospective study of reteplase efficacy for restoration of flow in occluded and poorly functioning hemodialysis catheters. Patients and methods: From May 1, 2001 to December 31, 2001, all hemodialysis patients seen at our university dialysis center with occluded or poorly functioning (< 200 ml/min blood flow) catheters treated with reteplase were included in the study. All catheters had been in place for more than 48 hours. Reteplase 0.4 U was instilled into each port; dwell time was 30 minutes. If aspiration had not been possible, reteplase had remained in the catheter for an additional 30 minutes. If flow was established (> 200 ml/min), the catheter was used for dialysis. If flow was not adequately established after 1 hour, the patient was referred for catheter exchange. Results: Reteplase (0.4 U) was used in 50 instances to restore or improve blood flow rates in a total of 23 catheters in 19 patients. Reteplase was effective in establishing adequate blood flow rates during the current and next dialysis session in 44/50 (88%) cases; 6 cases required 1-hour dwell time. Six cases (in 5 patients) required catheter exchange; in these, an anatomic or pathologic complication was responsible for catheter malfunction. No adverse events were related to reteplase instillation during the study. Conclusion: Data suggest that reteplase is safe and effective in restoring flow to malfunctioning hemodialysis catheters. Results are comparable to those achieved with alteplase.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalClinical Nephrology
Volume61
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Keywords

  • End-stage renal disease
  • Hemodialysis
  • Lysis
  • Patency
  • Reteplase

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