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| Author(s): |
Marcus Vinicius de Souza João Luiz
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Instituto de Ciências Biomédicas (ICB/SDI) |
| Defense date: | 2017-01-24 |
| Examining board members: |
Cristoforo Scavone;
Lucia da Conceição Andrade;
Luciana Biagini Lopes;
Patricia de Carvalho Mastroianni;
Tales Rubens de Nadai
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| Advisor: | Cristoforo Scavone; Carmen Tzanno Branco Martins |
| Abstract | |
Hydraulic Resistance is highly prevalent among long-term central venous catheters. Heparin catheter lock solutions are commonly used to maintain catheter patency, however this problem remains high. The purpose of the CLOCK Trial was to evaluate two catheter lock solutions as to their effectiveness and safety. Seventy-five CKD 5D patients on high-efficiency hemodialysis at the Integrated Centre of Nephrology (Guarulhos, Brazil) were randomized 1:1:1 to receive a lock solution combining minocycline 3 mg/ml with the anticoagulant/chelation agent EDTA 30 mg/ml (M-EDTA) or heparin 1,000 IU/ml (Heparin) or trisodium citrate 30% (Citrate) versus Heparin for 15 weeks. A total of 68 patients completed the trial in which both investigators and patients were blinded to treatment allocation. The primary end-point was the occurrence of hydraulic resistance and secondary safety end-point was adverse drug reactions related to the lock solutions. The incidence of hydraulic resistance was significantly higher among patients on Heparin (18/23) compared to Citrate (4/22) and M-EDTA (2/23) lock solutions, (p< 0.001). The trial suggests Citrate and M-EDTA may preserve catheter patency better than Heparin and they may show higher cost-effectiveness when compared to heparin. Citrate may be a better option due the lack of association with longterm antimicrobial resistance. (AU) | |
| FAPESP's process: | 13/07878-1 - Comparison of Effectiveness and Safety of Lock Solutions in Patients on Hemodialysis |
| Grantee: | Marcus Vinícius de Souza João Luiz |
| Support Opportunities: | Scholarships in Brazil - Doctorate |