Bibliographic Details
| Title: |
Clinical study on low-molecular weight heparin infusion as anticoagulation for nocturnal home haemodialysis. |
| Authors: |
STEVE SIU-MAN WONG, WAI-YAN LAU, MAN-LUEN NG, SHUK-YIN CHAN, SO-FAN CHAN, PING-KWAN CHAN, CHING-KIT WAN, YUK-LUN CHENG |
| Source: |
Nephrology; Apr2018, Vol. 23 Issue 4, p317-322, 6p |
| Subject Terms: |
ANTICOAGULANTS, HEPARIN, HEMODIALYSIS, CREATININE, THROMBOPLASTIN |
| Abstract: |
Aim: This study was conducted to evaluate low-molecular weight heparin (LMWH) as anticoagulation for nocturnal home haemodialysis (NHHD).While its longer half-life may cause drug accumulation in frequent dialysis, the essential need of a supplementary intra-dialytic bolus for the sleeping patients also renders LMWH's use impractical. Methods: The recruited patients, who were on alternate-day 8 h haemodialysis, were randomized to receive either nadroparin or unfractionated heparin (UFH) for aweek. They underwent crossover to receive the alternate anticoagulant in the next week. A nadroparin infusion regimen was adopted to enhance its practicability, which consisted of a loading dose of 35 IU/kg and a continuous infusion of 10 IU/kg per hour for 6 h. Results: A total of 12 NHHD patients were recruited. With nadroparin infusion, the mean anti-Xa levels at the 2nd, 4th, 6th and 8th hours of dialysis were 0.46 ± 0.11, 0.55 ± 0.14, 0.61 ± 0.15 and 0.45 ± 0.15 IU/mLrespectively. Comparing to UFH, which offered satisfactory anticoagulation according to the activated partial thromboplastin time, nadroparin-treated dialysis achieved similar thrombus scores and dialyser urea/creatinine clearances at the end of haemodialysis. During the post-dialysis period, one patient demonstrated residual LMWH effect (anti-Xa level 0.09 IU/mL) on the next day, whereas none had detectable anti-Xa activities 2 days afterwards upon next dialysis. Conclusions: Low-molecular weight heparin infusion is practical and effective as anticoagulation for NHHD. It can be safely used in an alternate-day haemodialysis schedule. Aclosemonitoring forLMWHaccumulation is recommended if long dialysis is performed daily. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
