Effects of ticlopidine on thrombotic obstruction of A-V shunts and on dialysance of artificial kidneys

Abstract

Administration of ticlopidine, a new inhibitor of platelet aggregation, during hemodialysis to two patients with thrombotic occlusion of external A-V shunts markedly suppressed the obstruction of the shunt and improved anemia. Consequently, it was concluded that this drug may be useful for maintaining good blood flow and good patency of shunts in patients undergoing dialysis. In order to determine the dialyzer efficiency during dialysis, the reduction rate of the dialyzer was determined in vitro. The dialyzer reduction rates for urea, creatinine, uric acid, and phosphoric acid were all lowered after dialysis, and the administration of ticlopidine resulted in a suppression of the drop in the reduction rate. Based on the inhibitory effect of ticlopidine on platelet aggregation, it was assumed that a close correlation may exist between adhesion and aggregation of platelets and the drop in the efficiency of the dialyzer during dialysis as well as thrombotic obstruction of shunts.