Clopidogrel decreases arteriovenous fistula thrombosis but does not improve fistula maturation.

Author(s): Gersch MS

Affiliation(s): Hot Springs Diagnostic Associates, Hot Springs, AR 71901, USA. michael_gersch@yahoo.com

Publication date & source: 2008-09, Nat Clin Pract Nephrol., 4(9):476-7. Epub 2008 Jul 29.

Publication type: Comment

This Practice Point commentary discusses Dember et al.'s randomized, double-blind, placebo-controlled trial of clopidogrel treatment after the creation of an arteriovenous fistula for dialysis. In total, 877 patients were treated with either placebo or clopidogrel (300 mg loading dose followed by 75 mg daily) for 6 weeks after fistula creation. Treatment with clopidogrel was associated with a significantly lower rate of fistula thrombosis than was placebo (12.2% vs 19.5%; P = 0.018). This reduction did not, however, lead to any changes in the secondary end point of attaining a useable access for dialysis; therefore, routine treatment with clopidogrel after fistula creation was not of clinical benefit in this well-conducted trial.