Thrombosis In Hemodialysis Patients Research Articles

Blood osteoprotegerin is associated with arteriovenous access thrombosis in hemodialysis patients

Blood osteoprotegerin is associated with arteriovenous access thrombosis in hemodialysis patients

Mechanical thrombectomy with the InThrill device for thrombosed hemodialysis access: A single center experience.

To assess the effectiveness and safety of the InThrill Thrombectomy System in treating thrombosed arteriovenous fistulas (AVFs) and grafts (AVGs) via mechanical thrombectomy. Institutional database was retrospectively searched to identify all thrombectomy procedures performed using the study device at our hospital for thrombosis of AVFs or AVGs. Inclusion criteria encompassed patients aged 18 and above who underwent AV access thrombectomy using the study device. Intraprocedural metrics, including procedure time, device time, blood loss, and adjunctive procedures were collected. Technical success was defined as restoration of flow combined with <30% residual diameter stenosis of the treated vascular segment. Clinical success was defined as the resumption of normal hemodialysis for a minimum of at least one session following intervention. Through 3-month follow-up, patency, and adverse events were evaluated. A total of 20 thrombectomies were performed on 2 AVFs and 18 AVGs in 13 patients. Median procedure and device times were 45 and 10 min, respectively. Balloon angioplasty was performed in all cases with additional stenting in 40% (8/20) of cases to address stenosis following thrombus removal. No other mechanical thrombectomy devices were utilized. Intraprocedural thrombolytics were not administered in any case. Average blood loss was 10 mL. The technical success and clinical success rates were 100% (20/20) and 95% (19/20), respectively. There were no intraoperative adverse events. One patient developed a post-operative minor hematoma, and one patient developed a post-operative pseudoaneurysm at the access site. The primary patency rate was 77% (10/13) at 1 month. Both assisted primary and secondary patency rates were 100% at 1 and 3 months. These preliminary results suggest that the InThrill Thrombectomy System is rapid, safe, and effective for thrombolytic-free treatment of AV access thrombosis in hemodialysis patients.

Role of Neutrophil Extracellular Traps in Vascular Access Thrombosis in Hemodialysis Patients

Role of Neutrophil Extracellular Traps in Vascular Access Thrombosis in Hemodialysis Patients

Role of neutrophil extracellular traps in vascular access thrombosis in hemodialysis patients

BackgroundA patent vascular access (VA) is a lifeline for hemodialysis (HD) patients. However, vascular access is prone to thrombosis, which, if left untreated, can lead to permanent VA loss and increased mortality. Neutrophil extracellular traps (NETs) are known to be involved in intravascular thrombosis. We evaluated the relationship between NETs and VA thrombosis and their impact on VA prognosis. MethodsA total of 189 patients with VA flow problems were enrolled. Among these, 93 patients underwent percutaneous transluminal angioplasty (PTA) for stenosis, and 96 patients underwent PTA with thrombectomy for thrombosis. Plasma nucleosome, myeloperoxidase-DNA complex, and von Willebrand factor (vWF) were measured as markers of circulating NETs and thrombosis risk, respectively. The primary outcome was permanent VA loss and the secondary outcome was recurrent thrombotic occlusion within 6 months. In addition, the presence of NETs in thrombi was evaluated by histopathological analysis. ResultsCirculating nucleosome levels were closely associated with plasma vWF levels (r = 0.172, p = 0.025), and both were higher in thrombectomy cases than in PTA alone cases (nucleosome; 0.83 ± 0.70 vs. 0.35 ± 0.26, p < 0.001, vWF: 9.0 ± 7.6 vs. 7.3 ± 6.2, p = 0.038). The highest quartile of nucleosomes (Q4) was associated with an 18-fold increased rate of access thrombotic occlusion (p < 0.001). In addition, multivariate analysis showed that the rates of permanent access loss (HR 2.77, 95 % CI 1.35–5.77) and recurrent thrombosis (HR 2.35, 95 % CI 1.22–4.54) were much higher in patients with the Q4 nucleosome group than in those with Q1–3. In addition, higher neutrophil infiltration and NET expression in thrombi were also associated with poor VA prognosis. ConclusionsHigher levels of circulating NETs and the amount of NET expression in thrombi may be associated with VA thrombosis and poor VA outcomes.

#4203 PREDICTION OF BLEEDING AND THROMBOSIS IN PATIENTS ON CHRONIC HEMODIALYSIS WITH THE TOTAL THROMBUS-FORMATION ANALYSIS SYSTEM

Abstract Background End-stage renal disease patients receiving hemodialysis (HD) are at increased risk of both bleeding and thrombotic complications. There are, however, few tools to help clinicians with risk stratification of the individual patient. Aims and Method To study if the Total Thrombus-formation Analysis System (T-TAS01), which measures thrombus formation in flowing whole blood inside a microchip [1], can be used to predict bleeding and thrombotic complications in patients on HD. Odds-ratios were calculated using the median split procedure. ROC curve analyses were performed to calculate the ability of T-TAS measurements performed at baseline to distinguish between patients with and without future bleeding or thrombotic complications. Results 176 patients on chronic HD were included and followed for one year; 11.4% were on antiplatelet drugs and 8.0% on continuous anticoagulation. Venous blood samples were taken at inclusion before dialysis procedure, and platelet-thrombus formation (PL-AUC; higher value reflects increased thrombogenicity) and platelet-fibrin thrombus formation (AR-OT; higher value reflects reduced thrombogenicity) were registered. Fifty-seven patients (32%) developed a bleeding complication, whereof 12 (6.8%) were ISTH major bleedings. The Odds-Ratio (OR; 95% CI) to develop any bleeding for patients with T-TAS01 measurements below (PL-AUC) or above (AR-OT) median were 7.67 (3.59-16.36) and 8.94 (4.10-19.51), respectively. ROC analyses to predict bleeding with T-TAS01 showed AUCs of 0.85 for all bleeding and 0.83 for ISTH major bleed (PL-AUC and AR-OT data combined). Furthermore, thirty-one patients (17.6%) developed a thrombotic complication, whereof 13 (7.4%) were acute coronary syndrome (ACS) or ischemic stroke (IS). The Odds-Ratio (OR; 95% CI) to develop any thrombosis for patients with T-TAS01 measurements below (PL-AUC) or above (AR-OT) median were 0.14 (0.05-0.40) and 0.28 (0.12-0.67), respectively. ROC analyses to predict thrombosis with T-TAS01 showed AUCs of 0.78 for all thrombosis and 0.62 for ACS/IS (PL-AUC and AR-OT data combined). Conclusion T-TAS01 is a promising tool to aid in the prediction of bleeding and thrombosis in HD patients.

Characteristic CT angiography findings and clinical value of catheter-related central venous thrombosis in hemodialysis patients with end-stage renal disease.

Central catheter-related thrombosis (CRT) is the most common catheter-related complication in patients with end-stage renal disease (ESRD) but is often underappreciated and misdiagnosed by radiologist. To find the computed tomography angiography (CTA) characteristics of central CRT, then raise the diagnosis of this disorder. A total of 301 eligible patients with ESRD who experienced both chest multi-phase multidetector CTA (MDCTA) and digital subtraction angiography were enrolled in the final analysis. The location, shape, and related signs of the central CRT in MDCTA images were evaluated. Independent-samples T test, chi-square test, and binary logistic regression were analyzed using SPSS software. In total, 166 patients were found to have CRT using MDCTA, and this was verified by DSA. Central CRT was usually irregular in the superior vena cava segment, and the angle of the contact area between central CRT and catheter was <180° (all P < 0.05). Age, collateral circulation, and venous stenosis were shown to have significant differences when compared to patients without CRT (all P < 0.05), but there were no significant differences about the sex or catheter insertion site. In addition, age and collateral circulation were the factors found to be significantly associated with thrombosis (P < 0.05). In particular, the thrombosis was 2.213 times more likely to be found in those patients with collateral circulation (odds ratio = 2.213, 95% confidence interval = 1.236-3.961). Chest multi-phase MDCTA can effectively reduce the missed diagnosis and misdiagnosis of central CRT. It is worth paying more attention to the central CRT especially when the collateral circulation is observed.

Genes predisposing tunneled catheter thrombosis in hemodialysis patients.

This study aims to investigate the association of genes predisposing thrombophilia with tunneled catheter thrombosis in hemodialysis patients. Between October 2018 and December 2020, we compared the frequencies of genetic polymorphisms causing thrombophilia, including prothrombin G20210A, factor V Leiden, methylene tetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C, plasminogen activator inhibitor (PAI), factor XIII V34L and clinical characteristics of 52 patients with a history of 2 tunneled2 tunneled catheter thrombosis occlusions within a year (Group 1; 24 males, 28 females; mean age: 62±8.9 years; range, 45 to 77 years), 52 patients who underwent their first tunneled catheter thrombosis insertion (Group 2; 29 males, 23 females; mean age: 63±15.2 years; range, 22 to 87 years), and 51 healthy controls (Group 3; 26 males, 25 females; mean age: 34±9.2 years; range, 19 to 54 years). Groups 1 and 2 carried the MTHFR A1298C (p=0.048) and compound heterozygous MTHFR A1298C and C677T (p=0.048) polymorphisms more frequently than Group 3. However, subgroup analysis results were not statistically significant. The other polymorphisms were distributed similarly in all three groups. The MTHFR polymorphisms had a weak effect on tunneled hemodialysis catheter thrombosis in neural network analysis. Our study results indicated that there was a concomitance of MTHFR polymorphisms with hemodialysis-dependent chronic kidney disease. The MTHFR A1298C and compound heterozygous MTHFR polymorphisms may be associated with tunneled hemodialysis catheter thrombosis. Thrombophilia gene screening may be recommended in hemodialysis patients undergoing tunneled hemodialysis catheter thrombosis at least twice in a year.

Genes predisposing tunneled catheter thrombosis in hemodialysis patients: Determination of sample size in clinical trials.

Genes predisposing tunneled catheter thrombosis in hemodialysis patients: Determination of sample size in clinical trials.

SERUM LEVEL OF VASCULAR CELL ADHESION MOLECULE AND P SELECTIN AS THROMBOPHILIC RISK FACTOR FOR EARLY VASCULAR ACCESS THROMBOTIC OCCLUSION IN HEMODIALYSIS PATIENTS

Hemodialysis (HD) vascular access (VA) failure is the dominant cause of morbidity and the major cost of care for ESRD patients. The aim of the present work is to assess the serum level of vascular cell adhesion molecule and P- selectin in HD patients as markers for early thrombotic VA event. 90 CKD patients divided into three groups: group I: 10 subjects apparently health, group II: 10 Patients with CKD stage IV-V on medical treatment and group III: 70 Patients with CKD stage V on HD with recent VA insertion divided into 2 subgroups: Subgroup III a: 57 patients with AV shunt and subgroup III b: 13 patients with permanent catheter. Laboratory investigations done (blood urea, serum creatinine, eGFR, CBC, PT, and INR), imaging and serum VCAM 1, P selectin before and 6 months after HD There was positive connection between VCAM and P selectin and dialysis with statistics in form of p value (<0.001). Markers level pre dialysis and after 6 months of dialysis revealed that range of p selectin and VCAM1 level after 6 months are higher than pre dialysis level. Detection of elevated serum level of circulating sVCAM-1 and s P-selectin could be useful in the prediction of native AVF and permanent catheter thrombosis in chronic HD patients. The association between sVCAM-1 and s P-selectin and thrombosis in HD patients increases the evidence of the role of adhesion molecules in VA thrombosis

Hemodialysis Patients with Higher Serum Levels of Soluble Receptor for Advanced Glycation End Products Have an Increased Risk for Arteriovenous Fistula Failure

Background: Arteriovenous fistula (AVF) failure due to thrombosis is a major cause of morbidity in patients undergoing regular hemodialysis (HD). Advanced glycation end products (AGEs) and their receptor (RAGE) might contribute to inflammation, neointimal hyperplasia, and thrombosis. RAGE has a C-truncated secretory receptor form, called soluble RAGE (sRAGE). In this study, we aimed to evaluate the association of serum sRAGE with AVF failure due to thrombosis in HD patients. Methods: Eighty-eight prevalent HD patients with functional AVF were included in the study. The presence of stenosis, clinical and laboratory data, and serum sRAGE was evaluated at inclusion. sRAGE concentration was measured by a competitive enzyme-linked immunosorbent assay, and stenosis was detected by ultrasound. Patients were prospectively followed up for 36 months. During this period, AVF failure (defined as the absence of blast or palpable thrill and impossible cannulation with 2 needles because of complete thrombosis) was noted and thrombosis was certified by ultrasound examination. Results: During follow-up, 16 (18.18%) patients lost their vascular access due to thrombosis. In multivariate Cox regression analysis, sRAGE was a significant predictor of vascular access thrombosis (hazard ratio = 1.15, 95% confidence interval: 1.03–1.25, p = 0.012). Kaplan-Meier analysis showed a significantly lower AVF patency time in patients with sRAGE >16.78 ng/mL than those with sRAGE <16.78 ng/mL (p = 0.02). In the subgroup of patients with stenosis at baseline, sRAGE, serum albumin, obesity, and ischemic heart disease were associated with thrombosis. Conclusion: In our study, baseline, systemic sRAGE is associated with the occurrence of thrombosis of AVF, and this marker has a significant impact on AVF survival.

Neutrophil extracellular traps and heparin-induced antibodies contribute to vascular access thrombosis in hemodialysis patients.

BackgroundAnti-heparin/platelet factor 4 (PF4) antibodies may trigger severe thrombotic complications in hemodialysis (HD) patients. Tetrameric PF4 has a high affinity for extracellular DNA, which is a key component of neutrophil extracellular traps (NETs); therefore, the interactions between anti-heparin/PF4 antibodies and NETs can contribute to prothrombotic events.MethodsAnti-heparin/PF4 antibody levels were measured by enzyme-linked immunosorbent assay and an optical density > 1.8 was regarded as clinically significant. We additionally measured serum nucleosome levels as representative markers of NETs, and the contributions of anti-heparin/PF4 and increased serum nucleosome levels to the primary functional patency loss of vascular access was assessed.ResultsThe frequency of anti-heparin/PF4 antibodies was significantly higher in incident HD patients compared to prevalent HD patients (23.6% vs. 7.7%). Serum nucleosome levels, as well as the white blood cell counts, neutrophil counts, and high- sensitivity C-reactive protein levels, were significantly higher in anti-heparin/PF4 antibody-positive patients compared to the control. Platelet counts tended to be lower in the patients with anti-heparin/PF4 of >1.8 than in the controls. Relative risk calculations showed that the presence of anti-heparin/PF4 antibodies increased the risk of primary functional patency failure by 4.28-fold, and this risk increased further with higher nucleosome levels. Furthermore, in the anti-heparin/PF4 antibody-positive group, the time to first vascular intervention was much shorter, and the risk of repeated intervention was higher, compared to the controls.ConclusionIn incident HD patients, the presence of anti-heparin/PF4 antibodies was associated with increased NET formation; this could be a strong predictor of vascular access complications

Arteriovenous fistulas thrombosis in hemodialysis patients with COVID-19.

The current Coronavirus disease 2019 (COVID-19) outbreak is associated with significant mortality, especially in patients suffering from end stage renal disease (ESRD) and hemodialysis patients. Several previous studies reported an over-risk of arterial and venous thrombosis, in particular pulmonary embolism and venous thrombosis of catheter in COVID19 patients in intensive care unit. However, arteriovenous fistula (AVF) thrombosis has rarely been reported yet in these patients. AVF thrombosis is a serious complication that impacts significantly patients outcome. Here, we aim to describe characteristics and prognosis of a cohort of COVID-19 hemodialysis (HD) patients presenting with AVF thrombosis. In the Ile de France region (Paris area) during the March 11th-April 30th 2020 period, fistula thrombosis cases were collected among COVID-19 hemodialysis patients in seven dialysis units and in interventional vascular departments. These patients' characteristics were analyzed through a review of the patient's medical records. Seventeen patients were included in our study (median age 69 years). Ten patients (59%) were men. Ten patients (59%) were diabetic and 88% had a high blood pressure. The mortality rate in these patients was 47%. All thrombosis treated with a declotting procedures (64%) were successfully cleared, but with early relapse in 36%. Our study highlights AVF thrombosis as a severe complication in COVID-19 hemodialysis patients that contributed to the severity and accelerated death.

Visit-to-visit systolic blood pressure variability associates with vascular thrombosis in hemodialysis patients

Abstract Background Blood pressure variability (BPV) is an independent risk factor for cardiovascular events and death in general population. Hemodialysis patients have higher BPV and higher vascular events than general population. However, the impact of BPV on vascular events of hemodialysis patients is not clear. Purpose To determine the association of BPV with vascular outcomes in patients on maintenance hemodialysis. Method In this prospective multi-center study, we enrolled 927 maintenance hemodialysis patients from Jan, 2017 to Dec, 2017. We used the coefficient of variation (CV) and the variance independent of mean (VIM) of predialysis systolic blood pressure (SBP) derived from the first 3 months (36 dialysis sessions) after enrollment as the metrics of BPV. Patients were prospectively followed at 3-month interval. Outcomes included death, systemic vascular thrombosis (nonfatal myocardial infarction, ischemic stroke, and acute limb ischemia), and dialysis vascular access thrombosis. Results In all, 707 subjects with at least 20 measurements were included in the analysis. Patients' mean age was 66 years and 50% of patients were male. Baseline factors associated higher BPV included diabetes, high co-morbidity scores, low albumin, high systolic and diastolic blood pressure. The mean pre-dialysis SBP CV was 10.9% and VIM was 28.9%. The median follow-up duration was 2.5 years, during which 103 deaths, 81 systemic vascular thrombosis, and 155 dialysis access thrombosis occurred. In unadjusted model, we found that the highest BPV tertile had a 52% increased risk of vascular thrombosis than the lowest BPV tertile (HR=1.52, 95% CI 1.23–1.86, P&amp;lt;0.001). After multivariable adjustment (including age, diabetes, co-morbidity score, albumin, baseline systolic and diastolic BP), this association remained statistically significant (HR=1.47, 95% CI=1.18–1.84, P=0.001). Systolic BPV was associated with either systemic vascular thrombosis (HR=1.44, 95% CI=1.08–1.93, P=0.01) or dialysis vascular access thrombosis (HR=1.55, 95% CI=1.16–1.82, P=0.001). Conclusion In the cohort of patients on maintenance hemodialysis, high pre-dialysis systolic BPV was associated a higher risk of vascular thrombosis events, both for systemic vascular thrombosis and dialysis vascular access thrombosis. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): National Taiwan University Hsinchu Branch

Are the platelet indices useful biomarkers of arteriovenous fistula thrombosis in hemodialysis patients?

Are the platelet indices useful biomarkers of arteriovenous fistula thrombosis in hemodialysis patients?

Risk Factors for Catheter Related Central Venous Thrombosis in Hemodialysis Patients

Risk Factors for Catheter Related Central Venous Thrombosis in Hemodialysis Patients

Management of tunneled-cuffed catheter-related right atrial thrombosis in hemodialysis patients

ObjectivesCatheter-related right atrial thrombosis (CRAT) is an underreported but potentially life-threatening complication associated with the use of tunneled-cuffed catheters among hemodialysis (HD) patients. Because little is known about the evidence-based guidelines for the optimal management of CRAT among HD patients, this article reports findings based on 20 patients diagnosed with CRAT after catheter replacement and anticoagulation treatment. MethodsThe article retrospectively reviews the hospital records of 20 HD patients treated in the West China Hospital with diagnosis of CRAT from March 2013 to May 2016. Once CRAT was diagnosed, tunneled-cuffed catheters were exchanged over a guidewire in situ and the locations of the new catheter tips were adjusted to be away from the original sites. Immediately after the insertion of a new tunneled-cuffed catheter and at the end of each HD session, both ports of the catheters were locked with unfractionated heparin solution. Patients younger than 70 years of age were treated with warfarin at a target International Normalized Ratio of 1.5 to 1.9, whereas those older than 70 years were treated with dual antiplatelet therapy. All patients were on regular dialysis without thrombolysis or thrombectomy. ResultsDuring the follow-up, two patients died of gastrointestinal massive hemorrhage and one died of acute myocardial infarction. No fatal pulmonary embolism or other CRAT complication-related deaths were observed. A total of eight patients had complete dissolution of CRAT, and 12 patients had reduction in thrombi size. ConclusionsMaintenance of HD by replacing catheters and providing oral anticoagulation/antiplatelet therapies may be an effective strategy for treating HD patients with CRAT.

Pulmonary embolism with endovascular thrombolysis for thrombosed hemodialysis arteriovenous access .

Acute thrombosis of hemodialysis (HD) arteriovenous access is an urgent problem for HD patients and is commonly managed by endovascular thrombolysis. Pulmonary embolism (PE) is a recognized complication of HD access thrombosis and thrombolysis but the risk and outcomes are unclear. This study aims to determine the incidence, predictors, and outcomes of PE after endovascular thrombolysis of HD arteriovenous access in patients presenting with acute thrombosis. A single-center retrospective study was performed for all adult chronic kidney disease patients undergoing arteriovenous access thrombolysis between January 1, 2012, and December 31, 2014. Investigation for PE with CT pulmonary angiography or ventilation/perfusion scintigraphy (V/Q scan) was performed as clinically directed by the managing clinicians. In cases diagnosed with PE, the pulmonary embolism severity index (PESI) was calculated. A total of 48 (median age 68) patients underwent 74 thrombolysis procedures. Thrombolysis techniques were divided into pharmacological (44.6%), mechanical (17.6%), or pharmacomechanical (37.8%). Clinical success was achieved in 56/74 (75.7%) of procedures. Five episodes of thrombolysis for access thrombosis (6.8%) were associated with clinically symptomatic PE. The PESI score ranged from 51 to 127. All patients with PE were managed with 3-6 months of anticoagulation and recovered clinically. There were no statistically significant differences in baseline characteristics, methods of thrombolysis, or clot burden in patients that developed a PE. There is a clinically significant risk of symptomatic PE after arteriovenous access thrombolysis for access thrombosis in HD patients. .

Deficiency of circulating progenitor cells associated with vascular thrombosis of hemodialysis patients.

Hemodialysis (HD) patients have an increased risk of thrombosis. Endothelial progenitor cells (EPCs), which function in vascular repair, are deficient in HD patients. Nonetheless, the relationship between EPC deficiency and thrombosis in HD patients is unknown. From January 2010 to December 2012, circulating levels of EPCs that were positive for CD34 and kinase insert domain receptor (KDR) were measured in 269 HD patients. Patients received prospective follow-ups at 6-month intervals until May 2015. The primary outcome was the composite of HD access thrombosis and systemic vascular thrombosis. There were 141 thrombotic events, 50 systemic vascular thrombotic events and 116 HD access thrombotic events. We found significantly negative associations between CD34 + KDR + tertile and overall thrombotic events (low: 61%; middle: 56%; high: 40%; P = 0.02), systemic vascular thrombotic events (low: 27%; middle: 18%; high: 10%; P = 0.03) and HD access thrombotic events (low: 52%; middle: 46%; high: 36%; P = 0.02). Univariate analysis indicated that systemic vascular thrombotic events were positively associated with age, diabetes, dyslipidemia, vascular disease history, urea clearance, albumin and C-reactive protein (CRP), and negatively associated with CD34 + KDR + cell count. HD access thrombosis was positively associated with vascular disease history and CRP, and negatively associated with CD34 + KDR + cell count. Multivariate analysis indicated that a low CD34 + KDR + cell count was an independent risk factor for both types of thrombosis. Our study of a population of HD patients showed that a low level of circulating EPCs is associated with thrombosis.

Circulating Fibroblast Growth Factor-23 Level and Paraoxonase-1 Lactonase Activity in Chronic Hemodialysis Patients: Their Impact on the Incidence of Native AV Fistula Thrombosis.

Thrombosis of native arteriovenous (AV) fistula is an important cause of complications in hemodialysis (HD) patients. The purpose of this study was to investigate the usefulness of measuring circulating fibroblast growth factor-23 (FGF-23) level and paraoxonase-1 (PON1) lactonase activity as potential predictors of native AV fistula thrombosis in chronic HD patients. This study included 83 HD patients (48 with thrombosed and 35 with non-thrombosed native AV fistulas) and 38 healthy volunteers. Serum FGF-23 level was measured using the ELISA technique, while serum PON1 lactonase activity was measured spectrophotometrically using gamma-thiobutyrolactone as a substrate. FGF-23 was significantly increased while PON1 lactonase was markedly decreased in both thrombosed and non-thrombosed HD patients compared with controls (P < 0.001). FGF-23 was elevated whereas PON1 lactonase was decreased in HD patients with thrombosed native AV fistulas compared with HD patients with non-thrombosed native AV fistulas (P = 0.001 and 0.002, respectively). A significant negative correlation was found between FGF-23 and PON1 lactonase in HD patients with thrombosed native AV fistulas (r = -0.342, P = 0.017). This study shows a potential value of FGF-23 and PON1 lactonase as predictors of native AV fistula thrombosis in HD patients.

A Novel Taurolidine Containing Catheter Lock Solution (CLS) Without Reported Antimicrobial Resistance, Reduces the Rates of Infection and Thrombosis in Hemodialysis Patients Enrolled in a Post-Approval Surveillance Study

A Novel Taurolidine Containing Catheter Lock Solution (CLS) Without Reported Antimicrobial Resistance, Reduces the Rates of Infection and Thrombosis in Hemodialysis Patients Enrolled in a Post-Approval Surveillance Study