Reducing blockage fails to improve access to the bloodstream for kidne...( Reducing early blockages in bloodst...),Health

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. Results were published May 14, 2008, 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 NIH Director Elias A. Zerhouni, M.D. "These results tell us we need to keep looking for solutions."

Hemodialysis filters waste and extra fluid from the bloodstream and requires a vascular access a site on the body where blood is removed and returned. Fistulas are the preferred type of access since they clot less often, experience fewer infections, and are less costly; patients with fistulas also have lower mortality. A fistula is created by joining a section of an artery and a vein to make one large vessel capable of handling high volumes of blood during hemodialysis. But maintaining any access site is a major clinical challenge. Blood clotting in the fistula is the most frequent cause of early fistula failure. Clotting, infection and low blood-flow rates in the access site are common reasons for hospitalizations requiring multiple treatments or surgeries. Read about vascular access at http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess.

The Dialysis Access Consortium (DAC) found that only 12 percent of patients developed blood clots in the fistula when treated with the clot-preventing drug clopidogrel, compared to nearly 20 percent of patients treated with placebo. Nevertheless, about 60 percent of new fistulas in each group could not be used for long-term dialysis treatments. Complications such as bleeding were similar across the s
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