Vascular access thrombosis in epoetin alfa therapy

Correcting anemia in hemodialysis patients may cause an increased incidence of vascular access clotting. Therefore, the incidence of clotting in patients before and during therapy with epoetin alfa was investigated. The records of 45 hemodialysis patients were accessed by computer for data concerning thrombectomy procedures and administration of epoetin alfa during two 13-week periods. Before therapy, 2 out of 45 patients had clotted accesses for a rate of .18 thrombectomy procedures per patient year. During therapy, 7 out of 45 patients had 11 clotted accesses for a rate of 1 thrombectomy procedure per patient year. Clotting incidence was shown to be increased during the epoetin alfa therapy period. The consequences of delaying a dialysis treatment due to a clotted access may be significant and even life-threatening. Both physicians and nurses must have a good understanding of the possible role of epoetin alfa in access thrombosis for patient management.