Pharmacotherapy to improve outcomes in vascular access surgery: a review of current treatment strategies

Andrew J. Jackson, Paul Coats, David B. Kingsmore

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Renal failure is a major cause of morbidity in western Europe, with rising prevalence. Vascular access complications are the leading cause of morbidity among patients on haemodialysis. Considering the health care burden of vascular access failure, there is limited research dedicated to the topic.  Randomised control trials of medications aimed at improving vascular access patency were identified using a medline search between January 1950 and January 2011.  Thirteen randomised trials were identified, investigating antiplatelets, anticoagulants and fish oil in preserving vascular access patency. Outcomes are presented and reviewed in conjunction with the underlying pathophysiological mechanisms of failure of vascular access.  Vascular access failure is a complex process. Most clinical trials so far have involved medications primarily aimed at preventing thrombosis. Other contributing pathways such as neointimal hyperplasia have not been investigated clinically. Improved outcomes may be seen by linking future therapies to these pathways.

LanguageEnglish
Pages2005-2016
Number of pages12
JournalNephrology Dialysis Transplantation
Volume27
Issue number5
Early online date13 Jan 2012
DOIs
Publication statusPublished - 31 May 2012

Fingerprint

Blood Vessels
Vascular Patency
Drug Therapy
Morbidity
Fish Oils
Therapeutics
Anticoagulants
Hyperplasia
Renal Insufficiency
Renal Dialysis
Thrombosis
Clinical Trials
Delivery of Health Care
Research

Keywords

  • arteriovenous shunt, surgical
  • drug therapy
  • humans
  • hyperplasia
  • neointima
  • platelet aggregation inhibitors
  • randomized controlled trials as topic
  • renal dialysis
  • renal insufficiency
  • retrospective studies
  • treatment outcome
  • vascular access devices

Cite this

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abstract = "Renal failure is a major cause of morbidity in western Europe, with rising prevalence. Vascular access complications are the leading cause of morbidity among patients on haemodialysis. Considering the health care burden of vascular access failure, there is limited research dedicated to the topic.  Randomised control trials of medications aimed at improving vascular access patency were identified using a medline search between January 1950 and January 2011.  Thirteen randomised trials were identified, investigating antiplatelets, anticoagulants and fish oil in preserving vascular access patency. Outcomes are presented and reviewed in conjunction with the underlying pathophysiological mechanisms of failure of vascular access.  Vascular access failure is a complex process. Most clinical trials so far have involved medications primarily aimed at preventing thrombosis. Other contributing pathways such as neointimal hyperplasia have not been investigated clinically. Improved outcomes may be seen by linking future therapies to these pathways.",
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Pharmacotherapy to improve outcomes in vascular access surgery : a review of current treatment strategies. / Jackson, Andrew J.; Coats, Paul; Kingsmore, David B.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 5, 31.05.2012, p. 2005-2016.

Research output: Contribution to journalArticle

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AU - Kingsmore, David B.

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KW - hyperplasia

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KW - randomized controlled trials as topic

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KW - renal insufficiency

KW - retrospective studies

KW - treatment outcome

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