Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Dialysis

Vascular access: not enough light at the end of the tunnel?

Graft stenosis, which can lead to thrombosis, is a major problem in hemodialysis patients with arteriovenous grafts. Does anti-aggregation with dipyridamole and aspirin help to prolong the primary patency of vascular access grafts?

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Dixon, B. S. et al. Effect of dipyridamole plus aspirin on hemodialysis graft patency. N. Engl. J. Med. 360, 2191–2201 (2009).

    Article  CAS  Google Scholar 

  2. Tordoir, J. et al. EBPG on Vascular Access. Nephrol. Dial. Transplant. 22 (Suppl. 2), ii88–ii117 (2007).

    PubMed  Google Scholar 

  3. Yahav, D. et al. Antimicrobial lock solutions for the prevention of infections associated with intravascular catheters in patients undergoing hemodialysis: systematic review and meta-analysis of randomized, controlled trials. Clin. Infect. Dis. 47, 83–93 (2008).

    Article  Google Scholar 

  4. Dember, L. M. et al. Effect of clopidogrel on early failure of arteriovenous fistulas for hemodialysis: a randomized controlled trial. JAMA 299, 2164–2171 (2008).

    Article  CAS  Google Scholar 

  5. Kaufman, J. S. et al. Randomized controlled trial of clopidogrel plus aspirin to prevent hemodialysis access graft thrombosis. J. Am. Soc. Nephrol. 14, 2313–2321 (2003).

    Article  CAS  Google Scholar 

  6. Osborn, G., Escofet, X. & Da, S. A. Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts. Cochrane Database of Systematic Reviews, Issue 2. Art. No. CD002786. doi:10.1002/14651858.CD002786.pub2 (2008).

  7. ESPRIT Study Group et al. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 367, 1665–1673 (2006).

  8. Chesebro, J. H. et al. Effect of dipyridamole and aspirin on late vein-graft patency after coronary bypass operations. N. Engl. J. Med. 310, 209–214 (1984).

    Article  CAS  Google Scholar 

  9. Hess, H., Mietaschk, A. & Deichsel, G. Drug-induced inhibition of platelet function delays progression of peripheral occlusive arterial disease. A prospective double-blind arteriographically controlled trial. Lancet 1, 415–419 (1985).

    Article  CAS  Google Scholar 

  10. Diener, H. C. et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J. Neurol. Sci. 143, 1–13 (1996).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raymond Vanholder.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vanholder, R., Verbeke, F. & Van Biesen, W. Vascular access: not enough light at the end of the tunnel?. Nat Rev Nephrol 5, 551–552 (2009). https://doi.org/10.1038/nrneph.2009.144

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2009.144

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing