Minimizing hemodialysis catheter dysfunction: An ounce of prevention

Timmy Lee, Charmaine Lok, Miguel Vazquez, Louise Moist, Ivan Maya, Michele Mokrzycki

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


The maintenance of tunneled catheter (TC) patency is critical for the provision of adequate hemodialysis in patients who are TC-dependent. TC dysfunction results in the need for costly and inconvenient interventions, and reduced quality of life. Since the introduction of TCs in the late 1980s, heparin catheter lock has been the standard prophylactic regimen for the prevention of TC dysfunction. More recently, alternative catheter locking agents have emerged, and in some cases have shown to be superior to heparin lock with respect to improving TC patency and reducing TC-associated infections. These include citrate, tissue plasminogen activator, and a novel agent containing sodium citrate, methylene blue, methylparaben, and propylparaben. In addition, prophylaxis using oral anticoagulants/antiplatelet agents, including warfarin, aspirin, ticlodipine, as well as the use of modified heparin-coated catheters have also been studied for the prevention of TC dysfunction with variable results. The use of oral anticoagulants and/or antiplatelet agents as primary or secondary prevention of TC dysfunction must be weighed against their potential adverse effects, and should be individualized for each patient.

Original languageEnglish (US)
Article number170857
JournalInternational Journal of Nephrology
StatePublished - 2012

ASJC Scopus subject areas

  • Nephrology


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