SHUNT THROMBOTIC OCCLUSION IN HEMODIALYSIS-PATIENTS - A PLEA FOR CLINICAL-TRIALS WITH ANTIPLATELET AGENTS

Thrombosis is the most common cause of vascular access loss in patient s on chronic hemodialysis. In addition, patients receiving renal repla cement. therapy suffer from a high incidence of ischemic cardiovascula r disease. Platelets play a central role both in the development of th rombosis and in the progression of ischemic cardiovascular disease thu s it is logic to use antiplatelet agents in hemodialysis patients. How ever, despite of 12 completed clinical trials with various antiplatele t drugs no golden therapeutic standard is yet available in this clinic al setting. The reasons that encourage to carry out controlled, prospe ctive, clinical trials with antiplatelet agents in chronic haemodialys is patients are reviewed.