A protocol of urokinase infusion and XXXX for the management of the thrombosed haemodialysis catheter.

@entity715 @entity409 @entity1229
BACKGROUND: @entity409 remains a significant cause of catheter loss and interrupted haemodialysis sessions. A number of regimens utilizing urokinase have been used but the optimum management of this common problem remains undetermined. METHODS: The study took place over 2 years and evaluated a protocol of urokinase infusion (25,000 U in 48 ml saline run at 4 ml/h via each limb of the catheter) followed by @entity1229 for restoration of catheter patency. RESULTS: Forty-eight urokinase infusions were used for 41 episodes of @entity409 . Catheter patency was restored in 95% and only one catheter was lost. Recurrent @entity715 occurred in eight of 10 catheters not anticoagulated. Once anticoagulated, catheters worked well. Further episodes of non-function were related to a sub-therapeutic INR. CONCLUSIONS: Our results show a high success rate for our protocol. We suggest an aggressive approach to the management of @entity715 with urokinase used by infusion and carefully controlled anticoagulation to maintain the INR in the range 2-2.5.
