The Urokinase Lock-Therapy for Hemodialysis Occluded Central Venous Catheters

Cavoli, Gioacchino Li; Schillaci, Onofrio; Zagarrigo, Carmela; Servillo, Franca; Cavoli, Tancredi Vincenzo Li; Palmeri, Mattia; Rotolo, Ugo

doi:10.1159/000381007

Cited by 2 publications

(4 citation statements)

References 4 publications

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“…There are few data on efficacy and cost-effectiveness to provide a rationale for this approach. 14,20,29 Pollo et al 27 showed that 18% of dysfunctional catheters required further treatment with urokinase because of persistent catheter dysfunction after first lock. Donati et al 14 mention more than 80% of catheters in the group receiving low dose urokinase (25,000 vs 100,000 IU per lumen) requiring a supplementary administration of urokinase because of insufficient restauration of blood flow.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the high number of TD episodes only 25 catheters of 236 (20.8%) had to be removed for refractory TD. The optimal dose of urokinase administered as locking solution in case of TD of the TCC has been the subject of several studies, with reported efficacy between 40% and 100% 12,14,19,20,23,[26][27][28] with a dose of urokinase varying from 5000 12,23,26,27 to 100,000 IU. 14…”

Section: Global Efficacy Of Urokinase Administration In Reversing Thrmentioning

confidence: 99%

“…Available evidence on TLS for TD is also limited because of small sample size and heterogeneity in the definition of both TD and its reversibility. 14,[18][19][20] Some dialysis units systematically use multiple consecutive thrombolytic locks as treatment for the same episode of TD without data on efficacy and cost-effectiveness of this strategy. 20 The objective of this retrospective study was to evaluate the efficacy of the short (intradialytic) and long (interdialytic) TLS protocols, defined by the capacity of a total dose of 100,000 IU of urokinase to restore Qb and adequate pump pressures of catheters with TD.…”

Section: Introductionmentioning

confidence: 99%

“…Available evidence on TLS for TD is also limited because of small sample size and heterogeneity in the definition of both TD and its reversibility. 14,18–20 Some dialysis units systematically use multiple consecutive thrombolytic locks as treatment for the same episode of TD without data on efficacy and cost-effectiveness of this strategy. 20…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of urokinase lock to treat thrombotic dysfunction of tunneled hemodialysis catheters: A retrospective cohort study

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Global Efficacy Of Urokinase Administration In Reversing Thrmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of urokinase lock to treat thrombotic dysfunction of tunneled hemodialysis catheters: A retrospective cohort study

et al. 2018

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Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient

Xia

Fan

et al. 2023

Open Medicine

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Catheter-related bloodstream infection (CRBSI) is a significant complication among patients on haemodialysis (HD) who are dependent on a central venous catheter (CVC) for an extended period. Catheter removal as first-line treatment can induce accelerated venous access site depletion in patients on HD who rely on it to survive. It is possible to retain the catheter in stable patients without septic syndrome while administering systemic antibiotics and antibiotic lock therapy. Herein, we report the case of a patient on HD with CRBSI who was successfully treated with intravenous levofloxacin- and urokinase-based antibiotic lock, without catheter removal prior to kidney transplantation. The use of urokinase in combination with antibiotics in lock solutions for treating catheter infections is rare. We verified the physical compatibility of levofloxacin and urokinase by visual inspection, turbidimetric measurements, and particle count. To our knowledge, this was a rare case demonstrating the effective use of urokinase and levofloxacin in a catheter lock for CRBSI in a patient on HD. Considering the need for highly concentrated antimicrobials and the availability of various antibiotics, the compatibility and stability of the lock solution is a matter of concern. Further studies are warranted to assess the stability and compatibility of various antibiotics in combination with urokinase.

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The Urokinase Lock-Therapy for Hemodialysis Occluded Central Venous Catheters

Cited by 2 publications

References 4 publications

Efficacy of urokinase lock to treat thrombotic dysfunction of tunneled hemodialysis catheters: A retrospective cohort study

Efficacy of urokinase lock to treat thrombotic dysfunction of tunneled hemodialysis catheters: A retrospective cohort study

Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient

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