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Clopidogrel decreases arteriovenous fistula thrombosis but does not improve fistula maturation

  • Practice Point
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From Nature Clinical Practice Nephrology

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Abstract

This Practice Point commentary discusses Dember et al.'s randomized, double-blind, placebo-controlled trial of clopidogrel treatment after the creation of an arteriovenous fistula for dialysis. In total, 877 patients were treated with either placebo or clopidogrel (300 mg loading dose followed by 75 mg daily) for 6 weeks after fistula creation. Treatment with clopidogrel was associated with a significantly lower rate of fistula thrombosis than was placebo (12.2% vs 19.5%; P = 0.018). This reduction did not, however, lead to any changes in the secondary end point of attaining a useable access for dialysis; therefore, routine treatment with clopidogrel after fistula creation was not of clinical benefit in this well-conducted trial.

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References

  1. US Renal Data System (2005) 2005 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases

  2. Vascular Access 2006 Work Group (2006) Clinical practice guidelines for vascular access. Am J Kidney Dis 48 (Suppl 1): S176–S247

  3. Konner K (2004) Vascular access for dialysis in diabetic patients. EDTNA ERCA J 30: 148–150

    Article  CAS  Google Scholar 

  4. Allon M and Robbin ML (2002) Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int 62: 1109–1124

    Article  Google Scholar 

  5. Dember LM et al. (2008) Effect of clopidogrel on early failure of arteriovenous fistulas for hemodialysis: a randomized controlled trial. JAMA 299: 2164–2171

    Article  CAS  Google Scholar 

  6. Beathard GA et al. (2003) Aggressive treatment of early fistula failure. Kidney Int 64: 1487–1494

    Article  Google Scholar 

  7. Kaufman JS et al. (2003) Controlled trial of clopidogrel plus aspirin to prevent hemodialysis access graft thrombosis. J Am Soc Nephrol 14: 2313–2321

    Article  CAS  Google Scholar 

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Author notes

  1. Hot Springs Diagnostic Associates, 1900 Malvern Avenue, Suite 301, Hot Springs, AR 71901, USA michael_gersch@yahoo.com

Authors and Affiliations

  1. MS Gersch is a Physician at Hot Springs Diagnostic Associates, Hot Springs, AR, USA.,

    Michael S Gersch

Authors
  1. Michael S Gersch
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The author declares no competing financial interests.

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Gersch, M. Clopidogrel decreases arteriovenous fistula thrombosis but does not improve fistula maturation. Nat Rev Nephrol 4, 476–477 (2008). https://doi.org/10.1038/ncpneph0908

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  • DOI: https://doi.org/10.1038/ncpneph0908

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