Kidney Week

Abstract: FR-PO430

Use of Alteplase in Long-Term Catheters Causes Hyperphosphataemia in Children on Hemodialysis

Session Information

• Pediatric Nephrology - I
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Vieira, Simone, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Simone Vieira,

• Carvalho, Maria fernanda Camargo, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Maria fernanda Camargo Carvalho,

• Henriques, Cristina, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Cristina Henriques,

• Bergamo, Samanta Loraine, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Samanta Loraine Bergamo,

• Rockenbach, Mariana Griebeler, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Mariana Griebeler Rockenbach,

• de Sá, Belise Kmentt Cavada, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Belise Kmentt Cavada de Sá,

• Genzani, Camila Penteado, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Camila Penteado Genzani,

• Gonçalves, Ilka Packer, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Ilka Packer Gonçalves,

• Hirata, Deborah, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Deborah Hirata,

• Scaranti, Vanessa, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Vanessa Scaranti,

• Takabatake, Eliane, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Eliane Takabatake,

• Koch Nogueira, Paulo C., Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Paulo C. Koch Nogueira,

Background

Alteplase has phosphoric acid in its composition, and catheter use may distort patients' phosphatemia depending on where the sample is collected. To investigate whether the use of Alteplase in the permeabilization of connectorized catheters influences the levels of serum P in children on hemodialysis (HD). To analyze the influence of the site and time of collection.

Methods

We studied 40 children in HD at Hospital Américas Samaritano, using Alteplase to avoid obstruction of the long-stay catheter. We analyzed 6 blood samples obtained following: 1. peripheral vein before the HD session; 2 after aspiration of the catheter lumen volume preserving the connector; 3 after the connector is removed; 4. Pre-filter collection when starting HD; 5: after 3 minutes of HD start; 6. After 5 minutes of initiation of hemodialysis.

Results

The age of the children ranged from 7 m to 17 years, 82.5% of males. The mean difference of the peripheral P (Sample 1) was with the others by the Bland Altman Plot method and 95% confidence interval outside: Sample 2: -12.32 (-15.75 to -8.89); Sample 3: -2.93 ( -4.12 to -1.73); Sample 4: 0,16 (cl -0,12 to 0,44); Sample 5: 1,04 ( cl 0,61 to 1,48); Sample 6: 1.33 (cl 0,89 to 1,77). The results showed agreement between the P in the peripheral blood and the collected prefilter.

Conclusion

Alteplase has phosphoric acid in its composition, and use in catheters may distort the phosphataemia of patients depending on the site of sample collection. Patients with a long-stay catheter in the use of alteplase should analyze the serum P after the withdrawal of the connector, aspiration of the lumen volume and prefilter collection after the onset of hemodialysis, under risk of false diagnosis of hyperphosphatemia and introduction of unnecessary treatments.