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Urokinase and dialysis therapy.

To the Editor: In a recent review by Schwab and Beathard on hemodialysis catheters, the authors did not acknowledge the value of systemic urokinase infusion to open clotted catheters1. Although they admit that the infusion appears to be safe and less expensive than either fibrin sheath stripping or catheter exchange, they also state that the "... primary disadvantage lies in the fact that [the infusion] requires four to six hours of hospital observation to facilitate payment for the urokinase."