Maier, J. (Jorina) (2017) „Incidence of vascular access thrombosis in lipid apheresis compared to hemodialysis. “. thesis, Medicine.
Full text available on request.Abstract
Background As the number of patients depending on extracorporeal therapy (e.g. lipid apheresis, hemodialysis) is rising with demographic change and medical advance, increasing importance lies on vascular access safety and patency. Main cause of vascular access failure is thrombosis. While possible influencing factors of access thrombosis in hemodialysis patients have been observed, none of the studies has dealt with the group of lipid apheresis patients so far. Clinical observation in Cloppenburg has raised the suspicion, that thromboses may occur more frequently in this patient group. Objective This study constitutes an initial assessment of frequencies of thromboses in lipid apheresis patients. The goal is to find out, whether lipid apheresis patients are more prone to vascular access thrombosis than hemodialysis patients and to discover and discuss possible influencing factors. Methods The study was designed retrospectively with an observation period of two and a half years. Routine data of patients undergoing lipid apheresis (n=13) in the center of nephrology in Cloppenburg was collected and compared to data of hemodialysis patients. Results Both, the proportion of thrombosis patients and the total amount of thromboses are significantly higher in the lipid apheresis group compared to hemodialysis patients. The lipid apheresis sample is characterized by a high proportion of manifested atherosclerotic comorbidities and upper arm vascular access. Conclusion The results substantiate the suspicion that access thromboses occur more frequently in lipid apheresis patients. Main suspected influencing factors are hypercoagulability, high blood lipids, including lipoprotein(a), and atherosclerotic comorbidities. An expanding study in prospective design controlling for age, gender, medication, access location and type should follow. If the results are confirmed, prophylactic medication of lipid apheresis patients and screening of all vascular access candidates for identified risk factors should be discussed.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Zeebregts, Prof. Dr. J. A. M. Universitair Medisch Centrum G |
| Supervisor name: | Supervisors: and Schrader, Prof. Dr. med. J. and St. Josefs-Hospital Cloppenburg and Lüders, PD Dr. med. S. St. Josefs-Hospital Cloppenburg and Location: Department of Nephrology, St-Josefs-Hospital Clopp |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/894 |
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