New Treatment for Dialysis Patients

[okarol]

New Treatment for Dialysis Patients

Submitted by Olivia Conroy on Fri, 01/28/2011 - 13:03 Health TNM Canada

There is good news for many Canadian patients on dialysis. A recent research has been done which assists in improving the life of many patients, who have been reeling under pain, post dialysis.

Earlier, the patients were given treatment thorough anticoagulant solution, heparin, inserted in the in the catheter line to prevent blood clots from forming between treatments. . But the recent research has unveiled another effective solution to reduce the cathere malfunction rate by 50%.

The study was conducted on 225 long term patients, selected randomly, out of which 115 were assigned to heparin only and another 110 received rt-PA along with two standard heparin treatments a week.

As per the study, catheters are placed in a vein to hook up dialysis patient to machine that purifies their blood. The current treatment, done by a drug known as rt-PA, which is normally used in treating people suffering from heart attack and strokes.

Dr. Brenda Hemmelgarn, a nephrologists and associate professor at the University of Calgary and her co-authors said a solution has expressed satisfaction over the results produced with the inclusion of this treatment.

Admitting the current treatment to be expensive, editorial author Dr. Wolfgang Winkelmayer of the Stanford University School of Medicine in Palo Alto, Calif has appealed for further probe to drive any conclusive results, to be used I clinical practices.

http://topnews.us/content/233458-new-treatment-dialysis-patients

[onestronglittlelady]

Unfortunately, the cost of this drug is much higher than heparin.

"One drawback to rt-PA is the price. In Canada, she said the monthly cost of heparin for a dialysis patient is about $156 per patient. But, a weekly dose of rt-PA costs about $582 a month. However, she noted that rt-PA may end up being more cost-effective in the long run if it prevents complications."
http://www.businessweek.com/lifestyle/content/healthday/649277.html

Does anyone know if this is being given to dialysis patients in the US?

[greg10]

Correct me if this is wrong, but hasn't this type of off-label use for tPA been around for a long time, as long ago as 2001.  It seems like the drug companies are just looking for more off-label use for drugs they already have.  I would suggest if a drug company did similar studies on the effect of aspirin on catheter occlusion, they may find beneficial effects as well.

http://www.factsandcomparisons.com/assets/hospitalpharm/Off1.pdf

http://medical-dictionary.thefreedictionary.com/Activase
alteplase (tissue plasminogen activator, recombinant) Warning - High-alert drug!

Actilyse (UK), Activase, Activase rt-PA (CA), Cathflo Activase, Lysatec rt-PA (CA)

Pharmacologic class: Plasminogen activator

Therapeutic class: Thrombolytic

Adverse reactions

CNS: cerebral hemorrhage, cerebral edema, CVA (with accelerated infusion)

CV: hypotension, bradycardia, recurrent ischemia, pericardial effusion, pericarditis , mitral regurgitation, electromechanical dissociation, arrhythmias, cardiogenic shock, heart failure, cardiac arrest, cardiac tamponade, myocardial rupture, embolization, venous thrombosis

GI: nausea, vomiting, GI bleeding

GU: GU tract bleeding

Hematologic: spontaneous bleeding, bone marrow depression

Musculoskeletal: musculoskeletal pain

Respiratory: pulmonary edema

Skin: bruising, flushing

Other: fever, edema, phlebitis or bleeding at I.V. site, hypersensitivity reaction (including rash, anaphylactic reaction, laryngeal edema ), sepsis
Interactions

Drug-drug. Aspirin, drugs affecting platelet activity (such as abciximab, heparin, dipyridamole, oral anticoagulants, vitamin K antagonists): increased risk of bleeding

Drug-diagnostic tests. Blood urea nitrogen: elevated level
Patient monitoring

• Monitor vital signs, ECG, and neurologic status.
• Maintain strict bed rest.
• Watch for signs and symptoms of bleeding tendency and hemorrhage.
• Monitor patient on Cathflo Activase for GI bleeding, venous thrombosis, and sepsis.
• Evaluate results of clotting studies.