Questions About PD
We thank you for your question. Some PD centres have reported administration of tissue plasminogen activator (tPA) (alteplase, Cathflo® Activase®) useful in dissolving fibrin in malfunctioning/obstructed PD catheters. While there is no standard protocol for use of tPA in a blocked PD catheter that we are aware of, the Canadian British Columbia Provincial Renal Agency has one protocol published on their website (1). Use of tissue plasminogen activator (tPA) is also discussed under the sub-heading Mechanical Complications in the recently published ISPD guideline for PD in Acute Kidney Injury (2, page 27).
1.British Columbia Provincial Renal Agency (2018). Alteplase (Cathflo®) Administration for Occluded Peritoneal Dialysis Catheter. Available at: http://www.bcrenalagency.ca/resource-gallery/Documents/Alteplase%20%28Cathflo%C2%AE%29%20Administration%20for%20Occluded%20Peritoneal%20Dialysis%20Catheter.pdf
2.Cullis B, Al-Hwiesh A, Kilonzo K, et al. ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 update (adults). Peritoneal Dialysis International. 2021;41(1):15-31. doi:10.1177/0896860820970834 Available at: https://journals.sagepub.com/doi/10.1177/0896860820970834