Prolonged Hemodialysis Catheter Survival With Copolymer Coating and Rt-PA

Inclusion Criteria: * End-stage kidney disease patients with newly inserted temporary untunnelled dual-lumen catheter * Naive to study but not naive to catheters (both virgin and non-virgin catheters will be included) * Expected to use catheter, and to dialyze at study centre, for at least six months * Frequency of HD 3 times per week * If indication for catheter was replacement for catheter related infection patients will be eligible after the infection has been treated and the patient has been off antibiotics for 3 HD sessions * Patient or legal representative able to provide written consent * Eighteen years of age or older * Baseline INR ≤ 1.3 (no anticoagulation allowed outside the HD session) * Baseline platelet count ≥ 60 x 109/L Exclusion Criteria: * Use of systemic anticoagulation (if indication for anticoagulation is catheter patency patients may be eligible if the systemic anticoagulation is discontinued and baseline INR is ≤ 1.3) * Insertion of a new catheter into the femoral vein * Current use of antibiotics for catheter-related bacteraemia (see inclusion criteria above) * Major haemorrhage in the prior 4 weeks, defined as bleeding resulting in a drop in haemoglobin of greater than 20 g/L or bleeding requiring transfusion of packed red blood cells with other clinical evidence or suspicion of bleeding * History of intra-cranial bleed in the prior 4 weeks * Intra-cranial or intra-spinal neoplasm (current) * Allergy or intolerance to rt-PA or heparin or its consti…