Effectiveness of Aspirin on Double Lumen Permanent Catheter Efficacy in ESRD

Abstract

BackgroundThe complications of vascular access are the most imperative etiology for hospitalization, morbidity and mortality in chronic hemodialysis. The most prevalent complication of central catheter is dysfunction due to thrombosis. Aspirin is an anti-aggregative platelet drug that may increase the patency of permanent catheters (perm-cath).ObjectivesThe aim of this study was to evaluate the role of Aspirin in perm-cath survival.Patients and MethodsThis study included a total of 185 ESRD cases according to the inclusion criteria for perm-cath insertion in hemodialysis. One hundred and eighty patients following perm-cath insertion had proper blood flow through perm-cath during hemodialysis. Patients were randomly divided between intervention (80 mg/day Aspirin initiated a day following catheter insertion) and control (placebo) groups. The average time that the perm-cath was functional was noted. Demographic characteristics included comorbidities and past history were also used to address probable influence on perm-cath function and patency.ResultsThe mean survival time of the catheter in Aspirin group was significantly higher than the control group (5.3 ± 4.7 month versus 3.9 ± 2.7 month, P = 0.012). No significant difference in major complications of Aspirin use (such as GI bleeding) was noted between two groups (P = 0.52). In terms of the patient’s demographic characteristics, those of the female gender and a history of diabetes mellitus were found to have significant influence on median survival rate of the catheters (P = 0.021, 0.043 respectively).ConclusionsThese results suggest that Aspirin use following perm-cath insertion might be beneficial for catheter survival. This increased survival time might enable patient’s use of AVF maturation for long term dialysis access.

Effect of aspirin in preventing thrombosis of tunneled dialysis catheters and increasing catheter survival in dialysis patients; controlled clinical trial study

“…In a study which was conducted by Mozafar et al, on the efficiency of aspirin on double lumen permanent catheter efficacy in endstage kidney failure on 180 patients with end-stage renal disease who were divided into two groups-control and intervention, the mean of catheter survival in two groups were compared. The average age of patients in this study was 71.1 which was almost equal to the present study (11). In the treatment group with aspirin, the mean survival time in the group was significantly higher than the control group (5.3 ± 4.7 years versus 3.9 ± 2.7 years; P = 0.012), which could be related to the significant positive effect of aspirin in our study as well.…”

“…The most important reason for their failure is the formation of clots, while its cause is not well-known (9). Recent studies have shown that aspirin not only acts as an antiplatelet, but also causes diminishing oxidative stress and inflammation (10,11).…”

Effects of Clopidogrel on Longevity of Permanent Double-Lumen Catheter Patency in Dialysis Patients: A Single-Blind Placebo-Controlled Clinical Trial

“…Shaffer et al reported a primary patency of 35% in the 1-year follow-up. In addition, Mozafar et al reported the mean survival of catheter to be 5.3 ± 4.7 months in the aspirin group (5). In our study, the survival rate of permcath at 4 and 5 months of follow-up was higher in the Clopidogrel group, compared to the placebo group.…”

“…VA complications are the most important causes of hospitalization and morbidity in end-stage renal disease patients. Success of hemodialysis depends on the patency and function of permanent catheter (permcath) (5). On the other hand, thrombosis is the most common complication of VA and permcath insertion for hemodialysis (6).…”

“…The search for an optimal, low-cost agent or agents, which can be orally administered to dialysis patients on a regular basis and extend the patency of catheters, remains a challenge for nephrologists. We previously assessed the beneficial effects of aspirin following permcath insertion on catheter survival and showed an increase in permcath survival, without any important complications associated with aspirin (5). According to the literature, the benefits of Clopidogrel, an antiplatelet agent, in the reduction of Copyright © 2018, Nephro-Urology Monthly.…”