Trial to Compare 1.0 Versus 2.0 mg Alteplase (tPA) Dosing in Restoring Hemodialysis Catheter Function
Status:
Unknown status
Trial end date:
2016-12-01
Target enrollment:
Participant gender:
Summary
Hemodialysis is a procedure that kidney physicians perform when the kidneys fail and can no
longer clean the blood and remove extra fluid and toxins from the body. Hemodialysis
therefore requires access to reach the blood through either a surgically created permanent
fistula or graft or through the insertion of a temporary catheter in one of the large body
veins. While the use of fistulas or grafts is preferred because they are permanent, there may
be conditions that prevent patients from having them and a hemodialysis catheter may be used
instead. The problem with the use of catheters however is that they can become blocked due to
the formation of blood clots. Kidney physicians try to resolve occlusion of hemodialysis
catheters by injecting a medication called Alteplase which breaks the clot at the catheter
site. There is no consensus in the medical community as to how much of the medication should
be injected at the occluded catheter site. While some kidney physicians and studies recommend
the use of 1.0 mg of the medication at each occlusion site, others recommend that 2.0 mg of
the medication should be used. Thus, the purpose of this randomized clinical trial is to
compare the effectiveness of 1.0mg versus 2.0mg dose of alteplase in resolving blood clots in
hemodialysis catheters.
The investigators will recruit patients for the study from a regional hemodialysis unit that
is located in southwestern Ontario. Patients who agree to participate in this research and
experiences occlusion of their hemodialysis catheters will be divided into two groups; making
sure that this division is completely by chance. The first group will receive 1.0mg
alteplase, while the second will receive 2.0mg Alteplase. The investigators will collect
information on both groups and will run statistical analysis of these information to compare
the results of clot resolution between the groups.