title: Tinzaparin is safe and effective in the management of hemodialysis catheter thrombosis.
abstract: Children on hemodialysis are at increased risk of thrombosis, especially when dialyzed via a central venous catheter (CVC); there are limited published data regarding the safety and efficacy of tinzaparin in this group. We conducted a retrospective chart review of all children in the National Pediatric Hemodialysis Centre for Ireland diagnosed with a CVC thrombus and treated with subcutaneous tinzaparin over a 10 year period. Seven children were treated with subcutaneous tinzaparin for 10 CVC thrombi. Tinzaparin was commenced at 175 IU/kg/day and the dose was titrated by measuring anti-factor Xa levels, aiming for levels of 0.3-1.0 IU/ml. Treatment was continued until resolution of the CVC thrombus. Restoration of normal flows during dialysis occurred within 3 days in all patients. There were no episodes of bleeding and all children tolerated the treatment well.
authors.affiliation: Department of Nephrology, The Children's University Hospital, Dublin, Ireland. CathyQuinlan@mac.com
authors.forename: Catherine
authors.initials: C
authors.lastname: Quinlan
authors.forename: Marie
authors.initials: M
authors.lastname: Bates
authors.forename: Melanie
authors.initials: M
authors.lastname: Cotter
authors.forename: Michael
authors.initials: M
authors.lastname: Riordan
authors.forename: Mary
authors.initials: M
authors.lastname: Waldron
authors.forename: Atif
authors.initials: A
authors.lastname: Awan
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D006435:Renal Dialysis / Q000009:adverse effects*; D013927:Thrombosis / Q000188:drug therapy*; D000078222:Tinzaparin
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin