[Prophylaxis and therapy of shunt thrombosis in terminal renal insufficiency (author's transl)]. 1977

H Köhler

In terminal renal insufficiency thrombosis occurs almost exclusively in the arteriovenous shunt. The management of this acute, life threatening thrombosis is hardly contested. On the other hand, few results are available concerning effective thrombosis prophylaxis. In addition to the effectiveness, the pharmacokinetics of a substance and also possible bleeding complications must be taken into account. The parenteral administration of heparin and its short half life restrict it to use in thehospital. Oral anticoagulants, because they are difficult to dose, should be avoided when possible. Dextrans (Rheomacrodex) and acetylsalicylic acid (Colfarit) appear to be best suited for thrombosis prophylaxis in renal insufficiency. Dextran has the disadvantage of volume overload, and acetylsalicylic acid that of stomach intolerance. Sulfinpyrazone (Anturano) also appears to be effective, although its pharmacokinetic behaviour in renal insufficiency is still not known. Dipyridamole (Persantin), whose effectiveness for this purpose has not yet been demonstrate, should be administered even more cautiously.

UI MeSH Term Description Entries
D003911 Dextrans A group of glucose polymers made by certain bacteria. Dextrans are used therapeutically as plasma volume expanders and anticoagulants. They are also commonly used in biological experimentation and in industry for a wide variety of purposes. Dextran,Dextran 40,Dextran 40000,Dextran 70,Dextran 75,Dextran 80,Dextran B-1355,Dextran B-1355-S,Dextran B1355,Dextran B512,Dextran Derivatives,Dextran M 70,Dextran T 70,Dextran T-40,Dextran T-500,Hemodex,Hyskon,Infukoll,Macrodex,Polyglucin,Promit,Rheodextran,Rheoisodex,Rheomacrodex,Rheopolyglucin,Rondex,Saviosol,Dextran B 1355,Dextran B 1355 S,Dextran T 40,Dextran T 500
D004176 Dipyridamole A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752) Antistenocardin,Apo-Dipyridamole,Cerebrovase,Cléridium,Curantil,Curantyl,Dipyramidole,Kurantil,Miosen,Novo-Dipiradol,Persantin,Persantine,Apo Dipyridamole,Novo Dipiradol
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006474 Hemorrhagic Disorders Spontaneous or near spontaneous bleeding caused by a defect in clotting mechanisms (BLOOD COAGULATION DISORDERS) or another abnormality causing a structural flaw in the blood vessels (HEMOSTATIC DISORDERS). Hemorrhagic Diathesis,Diatheses, Hemorrhagic,Diathesis, Hemorrhagic,Disorder, Hemorrhagic,Disorders, Hemorrhagic,Hemorrhagic Diatheses,Hemorrhagic Disorder
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D001166 Arteriovenous Shunt, Surgical Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed) Shunt, Surgical Arteriovenous,Surgical Arteriovenous Shunt,Arteriovenous Shunts, Surgical,Shunts, Surgical Arteriovenous,Surgical Arteriovenous Shunts
D001241 Aspirin The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5) Acetylsalicylic Acid,2-(Acetyloxy)benzoic Acid,Acetysal,Acylpyrin,Aloxiprimum,Colfarit,Dispril,Easprin,Ecotrin,Endosprin,Magnecyl,Micristin,Polopirin,Polopiryna,Solprin,Solupsan,Zorprin,Acid, Acetylsalicylic
D013442 Sulfinpyrazone A uricosuric drug that is used to reduce the serum urate levels in gout therapy. It lacks anti-inflammatory, analgesic, and diuretic properties. Sulfoxyphenylpyrazolidin,Anturan,Anturane,Apo-Sulfinpyrazone,Nu-Sulfinpyrazone,Sulphinpyrazone,Apo Sulfinpyrazone,Nu Sulfinpyrazone

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