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Purpose: End-Stage Renal Disease (ESRD) is a severe form of chronic kidney disease (CKD). Hemodialysis has increased the life expectancy in patients with renal failure. The most common complication of vascular access is thrombosis in lines. Medical interventions such as anti-thrombolytic drugs can be more effective and affordable. In this study, we aimed to evaluate streptokinase efficacy on the success rate and secondary patency rate of thrombosed hemodialysis catheters. Methods: In this prosepective study, 34 dialysis patients with thrombosed permicaths who entered to Razi hospital, were examined. The study population included the hospital during one year and three months. The cases received streptokinase, three times according to protocol. Each of the successful cases had been controlled after three months. After collection, the data were analyzed by SPSS version 21. Results: The frequency of males and females was too close. Findings showed that the Streptokinase was effective in 80 % of patients. And this effect continued for 22.1±18.2 months on average, and more than 70 % of patients' permcaths can be used after 3 months. More than 90% of patients didn't report any allergic reactions, and the allergic reactions have been limited to fever, nausea and back pain. Conclusion: The study showed although the replacement of occluded dialysis catheters is expensive and invasive, using streptokinase is effective and affordable, and is more secure than invasive methods. [ABSTRACT FROM AUTHOR]