Hemmelgarn BR, et al. - Researchers sought to assess efficacy as well as cost of recombinant tissue plasminogen activator (rt-PA) once per week as a hemodialysis locking solution, relative to thrice weekly citrate or heparin, in patients at high risk of complications. They found that once weekly rt-PA, when used as a catheter locking solution, was related to an attenuation in rt-PA use for treatment of catheter malfunction, a finding consistent with a prior randomized trial. However, a reduction in bacteremia or catheter stripping/removal was not observed in this study, although researchers did observe an increased incremental cost of this strategy primarily accounted for by the cost of the rt-PA.