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Effectiveness of aspirin on double lumen permanent catheter efficacy in ESRD
Mohammad Mozafar1, Majid Samsami, Mohammad Reza Sobhiyeh
1Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Insights
Aspirin use after permanent catheter insertion for hemodialysis significantly increases catheter survival time. This intervention may improve long-term dialysis access by promoting arteriovenous fistula maturation.
Area of Science:
- Nephrology
- Vascular Surgery
- Pharmacology
Background:
- Vascular access complications are a major cause of morbidity and mortality in chronic hemodialysis patients.
- Catheter dysfunction due to thrombosis is the most common complication of central venous catheters.
- Aspirin, an antiplatelet medication, may enhance the patency of permanent hemodialysis catheters (perm-caths).
Purpose of the Study:
- To evaluate the impact of Aspirin on the survival rate of permanent hemodialysis catheters.
- To determine if Aspirin can improve the longevity and function of perm-caths.
Main Methods:
- A randomized controlled trial involving 185 end-stage renal disease (ESRD) patients undergoing perm-cath insertion.
- Patients were assigned to receive either 80 mg/day Aspirin or a placebo, starting one day post-insertion.
- Catheter survival time and demographic factors influencing patency were analyzed.
Main Results:
- The mean catheter survival time was significantly longer in the Aspirin group (5.3 months) compared to the placebo group (3.9 months) (P=0.012).
- No significant increase in major complications, such as gastrointestinal bleeding, was observed with Aspirin use (P=0.52).
- Female gender and a history of diabetes mellitus were associated with a significant influence on catheter survival rates.
Conclusions:
- Aspirin administration following perm-cath insertion appears to be beneficial for enhancing catheter survival.
- Improved catheter longevity may facilitate arteriovenous fistula maturation, providing a more sustainable long-term dialysis access solution.
Background:
The 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).
Objectives:
The aim of this study was to evaluate the role of Aspirin in perm-cath survival.
Patients And Methods:
This 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.
Results:
The 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).
Conclusions:
These 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.
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