Successful use of alteplase for the treatment of hemodialysis catheter dysfunction due to thrombosis
DOI:
https://doi.org/10.69898/jhtm.35.2025.275908Keywords:
venous catheter thrombosis, hemodialysis, AlteplaseAbstract
Venous catheter dysfunction due to thrombosis is a prevalent complication among patients undergoing hemodialysis, impeding the normal operation of the dialysis process. The condition is typically managed using thrombolytic therapy, with alteplase being a widely used drug for dissolving clots in venous catheter. Alteplase works by activating plasminogen to plasmin, which in turn breaks down the fibrin clots, restoring blood flow through the catheter. This treatment is crucial in preventing further complications and ensuring the continuation of hemodialysis.
In this case report, a 52-year-old female patient with chronic kidney disease (CKD) who had been undergoing hemodialysis employing a venous catheter received a diagnosis of catheter-related thrombosis. Alteplase was administered intravenously in the catheter at an appropriate dose, which successfully dissolved the clot, improved blood circulation in the catheter and allowed the dialysis procedure to proceed normally. The patient experienced no significant side effects, and dialysis continued without the need for catheter replacement
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References
Wang L, Jia L, Jiang A. Pathology of catheter-related complications: what we need to know and what should be discovered. J Int Med Res. 2022 Oct;50:3000605221127890. doi: 10.1177/03000605221127890. PMID: 36268763; PMCID: PMC9597033.
Gunawansa N, Sudusinghe DH, Wijayaratne DR. Hemodialysis catheter-related central venous thrombosis: clinical approach to evaluation and management. Ann Vasc Surg. 2018;51:298-305.
Moradi Y, Golmohammadi S, Sobhieh M, Kalbasi S, Futuhi F. The evaluation of short-term and long-term effects of fibrinolytic drug Alteplase on catheters dysfunction in dialysis patients: Effects of Alteplase on catheters dysfunction. Stud Res Transl Med [Internet]. 2022 Dec 1 [cited 2024 Dec 1];4. Available from: https://vclass.sbmu.ac.ir/index.php/srtm/article/view/38617.
Selcuk E, Arıkan AA, Bayraktar FA. Outcomes of thrombolytic therapy of tunnelled hemodialysis catheter dysfunction. Vasc Endovasc Surg. 2021;55:811-6.
Altaf F, Wu S, Kasim V. Role of fibrinolytic enzymes in anti-thrombosis therapy. Front Mol Biosci. 2021 May 28;8:680397. doi: 10.3389/fmolb.2021.680397. PMID: 34124160; PMCID: PMC8194080.
Siriraj Hospital, Pharmaceutical and Therapeutic Committee. High-alert drug guidelines, Siriraj Hospital. 6th ed. Revised April 2022.
American Pharmacists Association. Drug Information Handbook with International Trade Names Index. 26th ed. Ohio: Lexicomp Inc.; 2017-2018.
Kaewphut V. Catheter access for hemodialysis. In: Sathirapoj B, Chaiprasert A, Nata N, Supasinth U, editors. Manual of dialysis. Bangkok: Namaksorn Printing; 2019. p. 75-90.
Anutarakunchaichirirat S. Vascular access: Practical point of care. In: Sathirapoj B, Chaiprasert A, Nata N, Supasinth U, editors. Manual of dialysis. Bangkok: Namaksorn Printing; 2019. p. 171-99.
Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4 Suppl 2):S1-S164.
Wang Y, Sun X. Reevaluation of lock solutions for Central venous catheters in hemodialysis: a narrative review. Ren Fail. 2022 Dec;44(1):1501-18.
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