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Efficacy and Safety of Clopidogrel in the Prevention of Primary Failure of Arteriovenous Fistula in Patients with End-Stage Renal Disease: A Systematic Review

ACTA MEDICA INDONESIANA · Vol. 55 No. 1 (2023)

ISSN
2338-2732, 0125-9326
Terbit
2023-03-31
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: Arteriovenous fistula (FAV) is the most widely used vascular access for end-stage renal disease (ESRD) patients undergoing routine hemodialysis in Indonesia. However, FAV can become dysfunctional before it is used for the initiation of hemodialysis, a condition known as primary failure. Clopidogrel is an anti-platelet aggregation that has been reported to reduce the incidence of primary failure in FAV compared to other anti-platelet aggregation agents. Through this systematic review, we aimed to assess the role of clopidogrel to the incidence of primary FAV failure and the risk of bleeding in ESRD patients. Methods: A literature search was carried out to obtain randomized Control Trial studies conducted since 1987 from Medline / Pubmed, EbscoHost, Embase, Proquest, Scopus, and Cochrane Central without language restrictions. Risk of bias assessment was performed with the Cochrane Risk of Bias 2 application. Results: All of the three studies involved indicated the benefit of clopidogrel for the prevention of AVF primary failure. However, all of the studies have substantial differences. Abacilar’s study included only participants with diabetes mellitus. This study also administered a combination of clopidogrel 75 mg and prostacyclin 200 mg/day, while Dember’s study gave an initial dose of clopidogrel 300 mg followed by daily dose 75 mg and Ghorbani’s study only gave clopidogrel 75 mg/day. Ghorbani and Abacilar started the intervention 7-10 days before AVF creation, while Dember started 1 day after VAF creation. Dember gave treatment for 6 weeks with an assessment of primary failure at the end of week 6, Ghorbani’s treatment lasted for 6 weeks with an assessment at week 8, while Abacilar gave treatment for one year with an assessment at weeks 4 after AVF creation. In addition, the prevalence of bleeding did not differ between the treatment and control groups. Conclusion: Clopidogrel can reduce the incidence of primary FAV failure without significant increase of bleeding events.

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  • University of Indonesia
  • Institut Agama Islam Negeri Bone
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Rekan penulisOrganisasiArtikel bersama
Rudi PutrantoAfiliasi tidak diketahui31
Cleopas Martin RumendeAfiliasi tidak diketahui16
Siti SetiatiAfiliasi tidak diketahui15
Edward FaisalAfiliasi tidak diketahui10
Murdani AbdullahAfiliasi tidak diketahui10
Imam SubektiAfiliasi tidak diketahui9
Alvina WidhaniAfiliasi tidak diketahui9
Eka GinanjarAfiliasi tidak diketahui9
Dadang MakmunAfiliasi tidak diketahui7
Idrus AlwiAfiliasi tidak diketahui7
Kuntjoro HarimurtiAfiliasi tidak diketahui7
Sally Aman NasutionAfiliasi tidak diketahui7
Arif MansjoerAfiliasi tidak diketahui7
Irsan HasanAfiliasi tidak diketahui6
Juferdy KurniawanAfiliasi tidak diketahui6
Iris RengganisAfiliasi tidak diketahui5
Robert SintoAfiliasi tidak diketahui5
Cosphiadi IrawanAfiliasi tidak diketahui5
Dina ElitaAfiliasi tidak diketahui5
Achmad FauziAfiliasi tidak diketahui5
Leonard NainggolanAfiliasi tidak diketahui5
Chyntia Olivia Maurine JasirwanAfiliasi tidak diketahui5
Tri Juli Edi TariganUniversity of Indonesia4
Andhika RachmanAfiliasi tidak diketahui4
Pradana SoewondoAfiliasi tidak diketahui4
Khie Chen LieAfiliasi tidak diketahui4
Muhammad YaminInstitut Agama Islam Negeri Bone4
Dyah PurnamasariAfiliasi tidak diketahui4
Lugyanti SukrismanAfiliasi tidak diketahui3
Muhadi MuhadiAfiliasi tidak diketahui3
Soekamto KoesnoeAfiliasi tidak diketahui3
Dicky Levenus TahaparyAfiliasi tidak diketahui3

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Efficacy and Safety of Clopidogrel in the Prevention of Primary Failure of Arteriovenous Fistula in Patients  with End-Stage Renal Disease: A Systematic Review</dc:title>
	<dc:creator>Wahyudi, Wahyudi</dc:creator>
	<dc:creator>Antono, Dono</dc:creator>
	<dc:creator>Nugroho, Pringgodigdo</dc:creator>
	<dc:creator>Rinaldi, Ikhwan</dc:creator>
	<dc:creator>Wijaya, Ika Prasetya</dc:creator>
	<dc:creator>Shatri, Hamzah</dc:creator>
	<dc:creator>Yunir, Em</dc:creator>
	<dc:creator>Rusdi, Lusiani</dc:creator>
	<dc:subject xml:lang="en-US">arteriovenous fistula</dc:subject>
	<dc:subject xml:lang="en-US">primary failure</dc:subject>
	<dc:subject xml:lang="en-US">clopidogrel</dc:subject>
	<dc:subject xml:lang="en-US">end-stage renal disease</dc:subject>
	<dc:subject xml:lang="en-US">systematic review</dc:subject>
	<dc:description xml:lang="en-US">Background: Arteriovenous fistula (FAV) is the most widely used vascular access for end-stage renal disease (ESRD) patients undergoing routine hemodialysis in Indonesia. However, FAV can become dysfunctional before it is used for the initiation of hemodialysis, a condition known as primary failure. Clopidogrel is an anti-platelet aggregation that has been reported to reduce the incidence of primary failure in FAV compared to other anti-platelet aggregation agents. Through this systematic review, we aimed to assess the role of clopidogrel to the incidence of primary FAV failure and the risk of bleeding in ESRD patients. Methods: A literature search was carried out to obtain randomized Control Trial studies conducted since 1987 from Medline / Pubmed, EbscoHost, Embase, Proquest, Scopus, and Cochrane Central without language restrictions. Risk of bias assessment was performed with the Cochrane Risk of Bias 2 application. Results: All of the three studies involved indicated the benefit of clopidogrel for the prevention of AVF primary failure. However, all of the studies have substantial differences. Abacilar’s study included only participants with diabetes mellitus. This study also administered a combination of clopidogrel 75 mg and prostacyclin 200 mg/day, while Dember’s study gave an initial dose of clopidogrel 300 mg followed by daily dose 75 mg and Ghorbani’s study only gave clopidogrel 75 mg/day. Ghorbani and Abacilar started the intervention 7-10 days before AVF creation, while Dember started 1 day after VAF creation. Dember gave treatment for 6 weeks with an assessment of primary failure at the end of week 6, Ghorbani’s treatment lasted for 6 weeks with an assessment at week 8, while Abacilar gave treatment for one year with an assessment at weeks 4 after AVF creation. In addition, the prevalence of bleeding did not differ between the treatment and control groups. Conclusion: Clopidogrel can reduce the incidence of primary FAV failure without significant increase of bleeding events.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2023-03-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">systematic review, meta-analysis</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2208</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 55 No. 1 (2023): Acta Medica Indonesiana; 19</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2208/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2023 Wahyudi Wahyudi</dc:rights>
</oai_dc:dc>