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Arteriovenous-Shunt Thrombosis — Prevention by Sulfinpyrazone

List of authors.
  • A. Kaegi, M.B., M.R.A.C.P.,
  • G. F. Pineo, M.D., F.R.C.P. (C),
  • A. Shimizu, M.D., F.R.C.P. (C),
  • H. Trivedi, M.D., F.R.C.P. (C),
  • J. Hirsh, M.D., F.R.A.C.P., C.R.C.P. (C),
  • and M. Gent, M.SC.

Abstract

The effects of sulfinpyrazone and a placebo on the incidence of thrombosis of arteriovenous shunts was investigated in a double-blind study in 52 patients on chronic hemodialysis over a six-month period. Thrombi occurred in 86 per cent of patients on placebo and 50 per cent of those on sulfinpyrazone (p<0.01). The incidence of thrombosis was reduced from 0.76 thrombi per patient month in the placebo group to 0.18 thrombi per patient month in the sulfinpyrazone group (p<0.001). Venous-shunt revisions were required in 48 per cent of patients given placebo and in only 16 per cent of those receiving sulfinpyrazone (p<0.05). Side effects were minimal and necessitated withdrawal from the study in only one patient. This study supports the results of animal experiments showing that sulfinpyrazone decreases thrombus formation the high-flow systems. (N Engl J Med 290:304–306, 1974)

Funding and Disclosures

Supported in part by the St. Joseph's Hospital Foundation and the Ontario Heart Foundation.

* Sulfinpyrazone and placebo kindly provided by Ciba-Geigy Pharmaceuticals.

We are indebted to Dr. Roy Ellis, medical director, Ciba-Geigy Canada, Ltd., for providing drug and placebo for this study, and to the nurses and residents of the Hemodialysis Unit for co-operation.

Author Affiliations

From the departments of Internal Medicine and Clinical Epidemiology and Biostatistics, St. Joseph's Hospital and McMaster University, Hamilton, Ontario (address reprint requests to Dr. Pineo at St. Joseph's Hospital, 50 Charlton Ave. East, Hamilton, Ontario L8N 1Y4.)

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