Abstract

MARTIN LORENZO, Amelia; BARTOLOME RAPADO, Mª Cristina  and  TAMERON NIETO, Arsenio. Early application of urokinase, the "key" to unblocking permanent catheters. Rev Soc Esp Enferm Nefrol [online]. 2005, vol.8, n.2, pp.98-102. ISSN 1139-1375.

Obstruction by fibrin deposits is the most frequent complication in permanent catheters for haemodialysis. In our unit, the use of Urokinase (UK) to unblock catheters did not give good results, so we decided to alter the protocol of use on the basis of one of the properties of UK: its therapeutic effectiveness increases with more recent thrombosis; we applied the same dose 7500 ui, but at an early stage. We introduced the new protocol in March 2003 and retrospectively studied the 8 months previous to the new protocol in three catheters and another 8 months prospectively with the current protocol. The results were satisfactory, as we managed to permeabilise a totally obstructed catheter and improve all the flows of the catheters under study. We currently have a further three new catheters in which no complete blockage has occurred, which has led us to believe that we could be performing a preventive job, for if we keep the span of the catheter entirely clean and the flows are good, it will be more difficult for them to be obstructed. The increased cost of the dialysis each time UK is used is 9.65€.

Keywords : Permanent catheters; Urokinase; Early administration; Coagulation.

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