Wrong Blood Thinners for Dialysis Patients Often Given: Study

A new study indicates that about 20% of dialysis patients are given blood thinners after angioplasty that could increase their risk of bleeding or death, despite FDA recommendations meant to avoid such medication errors.

The study, published in the December 9 issue of the Journal of the American Medical Association, found that many dialysis patients are prescribed enoxaparin (Lovenox) and eptifibatide (Integrilin) after angioplasty, despite a determination by the FDA that neither drug should be given to patients undergoing dialysis. Both drugs are contraindicated for dialysis patients on the labels.

The study looked at data on 22,778 dialysis patients who had undergone angioplasty between 2004 and 2008. Angioplasty is a procedure used to widen blood vessels to increase blood flow through arteries. Researchers found that 22.3% of patients who had undergone the procedure were given one of the two drugs.

Those dialysis patients given Lovenox or Integrilin had a 66% increased chance of in-hospital bleeding and potentially an increased risk of death as well.

The study’s author, Dr. Thomas Tsai, director of interventional cardiology at the Denver VA Medical Center, said that the study validated FDA’s contraindication of the two drugs for use with dialysis patients. Tsai said the revelation that doctors were giving dialysis patients drugs which had been specifically contraindicated on the label by the FDA “reflects poorly” on the health care process.

The study’s results did not identify where in the health care process the mistake of giving the dialysis patients the contraindicated drugs occurred. Tsai said that the findings should be used as a call to action at all levels of the health care process for those dealing with dialysis patients who receive angioplasty.