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Title: Reducing Blockage Fails to Improve Access to the Bloodstream for Kidney Dialysis
URL: http://www.pslgroup.com/dg/221E56.htm
Doctor's Guide
May 23, 2008

BETHESDA, Md -- May 23, 2008 -- Reducing early blockages in bloodstream access for kidney failure treatment does not increase the likelihood that the access will function adequately for long-term treatments, according to a study funded by the National Institutes of Health (NIH). Results were published May 14 in the Journal of the American Medical Association.

"Since most of the 470,000 Americans with kidney failure depend on hemodialysis for survival, there is a clear and compelling need to evaluate therapies that reduce or prevent access failure," said Elias A. Zerhouni, MD, Director, NIH. "These results tell us we need to keep looking for solutions."

The Dialysis Access Consortium (DAC), Bethesda, Maryland, found that only 12% of patients developed blood clots in the fistula when treated with the clot-preventing drug clopidogrel, compared with nearly 20% of patients treated with placebo. Nevertheless, about 60% of new fistulas in each group could not be used for long-term dialysis treatments.

The DAC studied nearly 900 patients at 9 US medical centres in academic and community practices in urban and rural settings. Participants received a new fistula and took the anti-platelet drug clopidogrel or a placebo tablet daily for 6 weeks to determine if the drug would maintain blood flow in fistulas and increase the number suitable for dialysis.

"Because vascular access is critical for delivering lifesaving care, we are already organising another multicentre study to look for other ways to improve fistulas," said co-author Catherine M. Meyers, MD, Program Officer, DAC, and Director, Inflammatory Renal Disease Program, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which funded the study.

The DAC Fistula Trial is the largest multicentre trial to look at preventing blood clots in new fistulas and the first to test whether prevention would allow more fistulas to be useable for dialysis.


SOURCE: US National Institutes of Health

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