Effect of short-term low molecular weight heparin on patency following successful salvage of arteriovenous access with recurrent thrombosis.
haemodialysis
thrombosis
vascular access
Journal
Nephrology (Carlton, Vic.)
ISSN: 1440-1797
Titre abrégé: Nephrology (Carlton)
Pays: Australia
ID NLM: 9615568
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
19
04
2020
revised:
01
11
2020
accepted:
11
11
2020
pubmed:
19
11
2020
medline:
11
11
2021
entrez:
18
11
2020
Statut:
ppublish
Résumé
This study aims to investigate the effect of low molecular weight heparin (LMWH) in maintaining the patency of arteriovenous (AV) access with recurrent thrombosis. Following successful thrombectomy, 66 patients with recurrent thrombosis were included in the study. The primary, assisted primary and secondary patency rates of patients who received LMWH (n = 24) were compared with those who did not receive anticoagulant (n = 42) using Kaplan-Meier analysis. Cox-regression analysis was performed to investigate potential predictors of patency rates. The mean dose of enoxaparin used was 40 ± 13.1 mg or 0.74 ± 0.2 mg/kg daily for a median duration of 14 (IQR 7,28) days. The mean trough anti-Xa concentrations measured after two doses of LMWH was 0.17 ± 0.13 IU/mL. Kaplan-Meier analyses for mean primary, assisted primary and secondary patency rates of LMWH vs no anticoagulation groups were 149 (95% CI: 91 - 207) vs 87 (95% CI: 42-132) days (P < .006), 230 (95% CI: 142-320) vs 107 (95% CI: 62-150) days (P = .01) and 438 (299-579) vs 294 (95% CI: 197-392) days (P = .08) respectively. LMWH remained a significant protective predictor of primary (HR: 0.49; 95% CI: 0.25-0.86; P = .02) and assisted primary patency rates (HR: 0.51; 95% CI: 0.27-0.98; P = .04) after adjusting for patient age, access age, type of AV access, presence of peripheral vascular disease and haemoglobin levels. LMWH may improve short and mid-term patency rates for AV accesses with recurrent thrombosis.
Substances chimiques
Fibrinolytic Agents
0
Heparin, Low-Molecular-Weight
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
350-357Informations de copyright
© 2020 Asian Pacific Society of Nephrology.
Références
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