Apixaban for the Prevention of Tunneled Cuffed Catheter Thrombosis in Hemodialysis Patients: A Randomized Controlled Trial
| Author | Khodadad Ghaffari | en |
| Author | Bahman Alinezhad | en |
| Author | Saman Ketabchian | en |
| Orcid | Khodadad Ghaffari [0009-0006-1064-1583] | en |
| Orcid | Bahman Alinezhad [0009-0009-3874-4375] | en |
| Orcid | Saman Ketabchian [0000-0002-4905-4363] | en |
| Issued Date | 2026-08-31 | en |
| Abstract | Background: Tunneled cuffed catheters (TCCs) provide essential vascular access for patients with end-stage kidney disease undergoing maintenance hemodialysis; however, they remain highly susceptible to thrombotic occlusion and subsequent failure. Objectives: This investigation evaluated the clinical efficacy and safety of low-dose oral apixaban for the prophylaxis of TCC-associated thrombosis and flow dysfunction. Methods: A double-blind, randomized controlled trial was conducted involving 100 adult patients requiring newly inserted TCCs at Imam Khomeini Hospital in Urmia, Iran, between 2023 and 2024. Participants were allocated in a 1:1 ratio to receive either 2.5 mg of oral apixaban daily or standard care for 6 months. The primary endpoint was catheter dysfunction, defined as a blood flow rate below 300 mL/min. Secondary outcomes included bleeding events and catheter replacement interventions. Results: Baseline clinical characteristics were well balanced between the two arms. Apixaban administration was associated with a statistically significant reduction in the rate of TCC thrombosis (8% vs 28%; P = 0.0196) and a reduced requirement for catheter replacement (6% vs 20%; P = 0.0353). Bleeding events did not differ significantly between the groups (2% vs 6%; P = 0.6098), and no major bleeding episodes were recorded. Conclusions: Prophylactic low-dose oral apixaban significantly reduced TCC-related thrombotic dysfunction and decreased catheter exchange rates in patients receiving chronic hemodialysis, demonstrating a favorable short-term safety profile without excessive bleeding. However, given the limited sample size, these findings should be interpreted with caution. Large-scale, multicenter randomized trials are needed to confirm these preliminary results and establish long-term clinical safety before routine adoption. | en |
| DOI | https://doi.org/10.5812/numonthly-172394 | en |
| URI | https://brieflands.com/journals/num/articles/172394 | en |
| Keyword | Apixaban | en |
| Keyword | Direct Oral Anticoagulants | en |
| Keyword | Tunneled Cuffed Catheter | en |
| Keyword | Catheter Thrombosis | en |
| Keyword | End-stage Kidney Disease | en |
| Keyword | Hemodialysis | en |
| Keyword | Vascular Access | en |
| Publisher | Brieflands | en |
| Title | Apixaban for the Prevention of Tunneled Cuffed Catheter Thrombosis in Hemodialysis Patients: A Randomized Controlled Trial | en |
| Type | Research Article | en |
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