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Influence of antiplatelet drugs on occlusion of arteriovenous fistula in uraemic patients

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Abstract

A long-standing arteriovenous (A-V) fistula may develop thrombotic complications.

In 20 patients on intermittent peritoneal dialysis (IPD) arteriovenous fistula was made surgically. We evaluated the efficacy of three antiplatelet drugs: Ibustrin (Group A), sulphinpyrazone (Group B) and alpha-tocopherol (Group C) in preventing thrombotic occlusion of A-V fistulas.

Results of the trial indicate that the three drugs significantly reduce spontaneous platelet aggregation and ADP induced aggregation. The heparin neutralizing activity was significantly increased during treatment. Significant prolongation of bleeding time was observed only in Groups B and C. In patients receiving antiplatelet drugs no occlusion of A-V fistulas was observed. In the control group such complications occured in 3 of the 20 patients.

Our results indicate that antiplatelet drugs by inhibiting the platelet function may prevent thrombotic occlusions of A-V fistulas in IPD patients.

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References

  1. Born, G. V. R.: Aggregation of blood platelets by adenosine diphosphate.Nature, 174, 927 (1962).

    Article  Google Scholar 

  2. Butler, A. M.: Vitamin E inhibits the release reaction of calcium from a platelet membrane fraction in vitro.Prostaglandins Med., 2, 203 (1979).

    Article  PubMed  CAS  Google Scholar 

  3. Butt, K. M. H.: Angioaccess. In: Drukker, W., Persons, F. M., Maher, J. F. (eds): Replacement of Renal Function by Dialysis. Martinus Nijhoff Publishers, Boston 1986, pp. 171–185.

    Google Scholar 

  4. Goldberg, J. P.: Intravenous streptokinase for thrombolysis of occluded arteriovenous access.Arch. Intern. Med., 145, 1405 (1985).

    Article  PubMed  CAS  Google Scholar 

  5. Graham, F. F., Wallis, R. B., Zelaschi, D.: The effect of sulphinpyrazone and its metabolites on platelet function in vitro and ex vivo.Haemostasis, 10, 165 (1981).

    Google Scholar 

  6. Ibals, L. S., Stewart, J. H., Mahony, J. J., Neale, F. C., Sheil, A. G. R.: Occlusive arterial disease in uraemia and haemodialysis patients and renal transplant recipients.Q. J. Med., 46, 197 (1977).

    Google Scholar 

  7. Karpen, C. W., Pritchard, K. A., Arnold, J. H., Cornell, D. G., Parganamala, R. V.: Restoration of prostacyclin thromboxane A2 balance in the diabetic rat: Influence of dietary vitamin E.Diabetes, 31, 947 (1982).

    CAS  Google Scholar 

  8. Mielke, C. H.: Template bleeding time: Technique. In: Platelet Function Testing. DHEW Publications No. (NIH) 78-1087, 1977, p. 723.

  9. Mion, C. M.: Practical use of peritoneal dialysis. In: Drukker, W., Persons, F. M., Maher, J. F. (eds): Replacement of Renal Function by Dialysis. Martinus Nijhoff Publishers, Boston 1986, pp. 457–492.

    Google Scholar 

  10. O'Brien, J. R., Etherington, M. D.: Heparin-thrombin clotting time and platelet factor 4.Lancet, 1, 656 (1974).

    Article  Google Scholar 

  11. Panno, N., Powell, C.: The creation, care, and complication of the subcutaneous hemodialysis access.Dialysis & Transplantation, 18, 308 (1989).

    Google Scholar 

  12. Pogliani, E. M., Colombi, M., Cristoforetti, G., Valenti, G., Miradoli, R., Buccianti, G.: Beta-thromboglobulin and platelet factor 4 plasma levels during haemodialysis: Effect of indobufen.Pharmatherapeutica, 3, 127 (1982).

    PubMed  CAS  Google Scholar 

  13. Saleem, A., Krieg, A., Cieślica, R.: Platelet activity ratio.Amer. J. Clin. Pathol., 232, 1303 (1975).

    Google Scholar 

  14. Salter, M. C. P., Mayor, P., Crow, M. J., Rajah, S. M., Davison, A. M.: Microthrombus formation on hemodialysis membranes: A placebo controlled randomized trial of two doses of indobufen.Clin. Nephrol., 24, 31 (1985).

    PubMed  CAS  Google Scholar 

  15. Tanaka, H., Uminoto, K., Izumi, N., Nishimoto, K., Yoshihara, H., Katoh, Y., Kishimoto, T., Maekawa, M.: Platelet dysfunction and its life span in uremia.Trans. Am. Soc. Artif. Intern. Organs, 30, 207 (1984).

    PubMed  CAS  Google Scholar 

  16. Watanabe, J., Umeda, F., Wakasugi, H., Ibayashi, H.: Effect of vitamin E on platelet aggregation in diabetes mellitus.Thromb. Haemostas., 51, 313 (1984).

    CAS  Google Scholar 

  17. Weber, M., Kuhn, F. P., Quintes, W., Keidl, E., Köhler, H.: Sonography of arteriovenous fistulae in hemodialysis patients.Clin. Nephrol., 22, 258 (1984).

    PubMed  CAS  Google Scholar 

  18. Wu, K. K., Hoak, J. C.: A new method for the quantitative detection of platelet aggregates in patients with arterial insufficiency.Lancet, 2, 924 (1974).

    Article  PubMed  CAS  Google Scholar 

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Janicki, K., Dmoszyńska, A., Janicka, L. et al. Influence of antiplatelet drugs on occlusion of arteriovenous fistula in uraemic patients. International Urology and Nephrology 24, 83–89 (1992). https://doi.org/10.1007/BF02552122

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  • DOI: https://doi.org/10.1007/BF02552122

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