A recent study from National Taiwan University Hospital shows that apixaban, a blood-thinning medication, can help prevent blood clots in dialysis patients after a procedure to clear blocked vascular access. Dialysis patients rely on vascular access—like fistulas or grafts—to filter their blood, but clots can form and block these pathways, making dialysis impossible.
The research team tested whether apixaban could stop these clots from coming back after a thrombectomy, a procedure to remove the blockage. The study included 186 patients split into two groups. One group received standard care, while the other got standard care plus apixaban (2.5 mg twice daily) for three months. After three months, the apixaban group had fewer clot recurrences—24% compared to 41% in the standard care group. This means apixaban cut the clot risk by nearly half.
It also improved the chances of keeping the vascular access working without further issues (32% failure rate versus 50% in the control group). These benefits lasted up to six months, even though the medication was only used for three. Safety-wise, apixaban didn't increase serious bleeding compared to standard care, though minor bleeding—like skin or gum bleeds—was more common (23% versus 8%). Most minor bleeds were manageable and didn't require stopping the drug.
The findings, published in Kidney International, suggest apixaban could be a helpful option for dialysis patients after thrombectomy, balancing clot prevention with acceptable risks. "This study offers hope for dialysis patients by showing apixaban can safely reduce clot risks," said Prof. Mu-Yang Hsieh.
More information: Tsung-Yu Ko et al, A randomized controlled trial evaluated the efficacy and safety of apixaban for prevention of recurrent thrombosis after thrombectomy of hemodialysis vascular access, Kidney International (2024). DOI: 10.1016/j.kint.2024.10.023
Journal information: Kidney International
Provided by National Taiwan University