Efficacy of urokinase in maintaining patency of hemodialysis catheters: A meta-analysis

Deng, Jiaxiu1; Luo, Weixiang2; Zhang, Weiwei3; Xiong, Shiyi4; Wang, Liping1

2024-07-01

10.5414/CN111239

CLINICAL NEPHROLOGY   影响因子和分区

0301-0430

Background: Catheter malfunctions are associated with reduced blood flow and interrupted dialysis during hemodialysis. Aim: This meta-analysis aimed to determine whether the use of urokinase to lock hemodialysis catheters can maintain their patency and prevent catheter-related bloodstream infections (CRBSIs). Materials and methods: The PubMed, Cochrane Library, Web of Science, Embase, and Chinese medical databases were searched for controlled trials of hemodialysis catheter locking using urokinase from database inception until July 15, 2021. The primary outcome was catheter malfunction, and the secondary outcomes were the peak catheter blood flow rate (Qb) and CRBSIs. Results: Across 16 trials, 1,041 patients were randomized to receive either urokinase/urokinase mixture (treated) or heparin (control) locks once or thrice a week. Locking with urokinase alone or in combination with another substance significantly prevented catheter malfunction. The effect on Qb was significant, with that in the treated group being better than in the control group. Similarly, the incidence of CRBSIs in the treated group was lower. Conclusion: Urokinase locking maintains catheter patency more effectively than heparin. Prophylactic locking with urokinase or urokinase mixtures reduces incidences of catheter malfunction, which ensures the smooth progression of hemodialysis and reduces patient medical costs. The results of this study have important clinical implications and will provide guidance to medical practitioners globally.

urokinase hemodialysis catheter catheter malfunction heparin

SCI

英语

第一 ; 通讯

Urology & Nephrology

Urology & Nephrology

WOS:001267224600001

DUSTRI-VERLAG DR KARL FEISTLE

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Jinan Univ, Affiliated Hosp 1, Dept Blood Purificat,Clin Med Coll 2,Shenzhen Peop, Shenzhen 518020, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Affiliated Hosp 1,Dept Nursing,Clin Med Coll 2, Shenzhen, Guangdong, Peoples R China
3.Southern Univ Sci & Technol, Jinan Univ, Affiliated Hosp 1, Dept Nephrol,Shenzhen Peoples Hosp,Clin Med Coll 2, Shenzhen, Guangdong, Peoples R China
4.Univ Hong Kong, Shenzhen Hosp, Dept Pain Management, Shenzhen, Guangdong, Peoples R China

Deng, Jiaxiu,Luo, Weixiang,Zhang, Weiwei,et al. Efficacy of urokinase in maintaining patency of hemodialysis catheters: A meta-analysis[J]. CLINICAL NEPHROLOGY,2024.

Deng, Jiaxiu,Luo, Weixiang,Zhang, Weiwei,Xiong, Shiyi,&Wang, Liping.(2024).Efficacy of urokinase in maintaining patency of hemodialysis catheters: A meta-analysis.CLINICAL NEPHROLOGY.

Deng, Jiaxiu,et al."Efficacy of urokinase in maintaining patency of hemodialysis catheters: A meta-analysis".CLINICAL NEPHROLOGY (2024).