Efficacy of reteplase in poorly functioning hemodialysis catheters.

Aim: This is a retrospective study of reteplase efficacy for restoration of flow in occluded and poorly functioning hemodialysis catheters. Patients and methods: From May 1, 2001 to December 31, 2001, all hemodialysis patients seen at our university dialysis center with occluded or poorly functioning ( 200 ml/min), the catheter was used for dialysis. If flow was not adequately established after I hour, the patient was referred for catheter exchange. Results: Reteplase (0.4 U) was used in 50 instances to restore or improve blood flow rates in a total of 23 catheters in 19 patients. Reteplase was effective in establishing adequate blood flow rates during the current and next dialysis session in 44/50 (88%) cases; 6 cases required 1-hour dwell time. Six cases (in 5 patients) required catheter exchange; in these, an anatomic or pathologic complication was responsible for catheter malfunction. No adverse events were related to reteplase instillation during the study. Conclusion: Data suggest that reteplase is safe and effective in restoring flow to malfunctioning hemodialysis catheters. Results are comparable to those achieved with alteplase.