Vitamin K antagonists in children with central venous catheter on chronic haemodialysis: a pilot study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-12-14

AUTHORS

Fabio Paglialonga, Andrea Artoni, Simon Braham, Silvia Consolo, Alberto Giannini, Giovanna Chidini, Luisa Napolitano, Ida Martinelli, Giovanni Montini, Alberto Edefonti

ABSTRACT

BackgroundTo date, no study has investigated the use of vitamin K antagonists (VKA) in children undergoing chronic haemodialysis (HD) with a central venous catheter (CVC).MethodsConsecutive patients aged <18 years with a newly placed tunnelled CVC for chronic HD were enrolled over a 3-year period. Children with active nephrotic syndrome or a history of venous thrombosis received warfarin (VKA group) with therapeutic target international normalised ratios of between 2.0 and 3.0. Patients at standard risk of CVC malfunction were not treated with VKA (standard group). The primary end-point was overall CVC survival.ResultsThe VKA group consisted of nine patients (median age 10.6 years; range 1.2–15.3 years) with 11 CVC, and the standard group comprised eight patients (11.8 years; 6.1–17.3 years) with ten CVC. The 6- and 12-month CVC survival was significantly longer in the VKA group than in the standard group (100 vs. 60 % and 83.3 vs. 16.7 %, respectively; p < 0.05), with a median survival of 369 and 195 days, respectively (p < 0.05). None of the CVC in the VKA group required removal due to malfunction, as compared to four in the standard group. No major bleeding episodes occurred in either group.ConclusionsTherapy with VKA would appear to be safe in children on chronic HD and may improve CVC survival in patients at increased risk of CVC thrombosis. More... »

PAGES

827-832

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-015-3293-1

DOI

http://dx.doi.org/10.1007/s00467-015-3293-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1008313955

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26667238


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40 schema:description BackgroundTo date, no study has investigated the use of vitamin K antagonists (VKA) in children undergoing chronic haemodialysis (HD) with a central venous catheter (CVC).MethodsConsecutive patients aged <18 years with a newly placed tunnelled CVC for chronic HD were enrolled over a 3-year period. Children with active nephrotic syndrome or a history of venous thrombosis received warfarin (VKA group) with therapeutic target international normalised ratios of between 2.0 and 3.0. Patients at standard risk of CVC malfunction were not treated with VKA (standard group). The primary end-point was overall CVC survival.ResultsThe VKA group consisted of nine patients (median age 10.6 years; range 1.2–15.3 years) with 11 CVC, and the standard group comprised eight patients (11.8 years; 6.1–17.3 years) with ten CVC. The 6- and 12-month CVC survival was significantly longer in the VKA group than in the standard group (100 vs. 60 % and 83.3 vs. 16.7 %, respectively; p < 0.05), with a median survival of 369 and 195 days, respectively (p < 0.05). None of the CVC in the VKA group required removal due to malfunction, as compared to four in the standard group. No major bleeding episodes occurred in either group.ConclusionsTherapy with VKA would appear to be safe in children on chronic HD and may improve CVC survival in patients at increased risk of CVC thrombosis.
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47 schema:keywords BackgroundTo date
48 CVC malfunction
49 CVC survival
50 CVC thrombosis
51 ConclusionsTherapy
52 MethodsConsecutive patients
53 VKA group
54 active nephrotic syndrome
55 antagonist
56 bleeding episodes
57 catheter
58 central venous catheters
59 children
60 chronic haemodialysis
61 date
62 days
63 episodes
64 group
65 haemodialysis
66 history
67 major bleeding episodes
68 malfunction
69 median survival
70 nephrotic syndrome
71 patients
72 period
73 pilot study
74 ratio
75 removal
76 risk
77 standard group
78 standard risk
79 study
80 survival
81 syndrome
82 target
83 therapeutic target
84 thrombosis
85 use
86 venous catheters
87 venous thrombosis
88 vitamin K
89 vitamin K antagonists
90 warfarin
91 years
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