Hemodialysis with defibrotide: effects on coagulation parameters.
In a crossover study conducted with eight uremic patients maintained on hemodialysis, the Authors compared the effects of heparin (100 IU/kg at the start of dialysis) and defibrotide (400 mg at the start, repeated at 2 hours of ongoing dialysis) on the parameters of blood coagulation (VIII:C, AT III, TAT, PC antigen and activity, PS, and FPA), each being assessed before dialysis and at 2, 3 and 4 hours of the ongoing procedure. Heparin-assisted dialysis resulted in a significant rise of VIII:C and AT III; with defibrotide, instead, there was evidence of thrombin activation (increased FPA and TAT). PC levels were raised with both dialysis modalities; however, PC activity and PS levels were increased only in defibrotide-assisted dialysis. There were no adverse reactions or evidence of fibrin formation. These results confirm the antithrombotic activity of defibrotide in the course of dialysis and indicate that this action is independent of thrombin neutralization.
Filimberti
E
E
Hemophilia Center, Careggi Hospital, USL 10/D, Firenze, Italy.
Cinotti
S
S
Salvadori
M
M
Amato
M
M
Longo
G
G
Nazzari
M
M
Morfini
M
M
D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation / Q000187:drug effects*; D005169:Factor VIII / Q000032:analysis; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D005344:Fibrinopeptide A / Q000032:analysis; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D010447:Peptide Hydrolases / Q000032:analysis; D011089:Polydeoxyribonucleotides / Q000494:pharmacology*; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D006435:Renal Dialysis / Q000379:methods*
D005343:Fibrinolytic Agents; D011089:Polydeoxyribonucleotides; D011486:Protein C; D017293:Protein S; C046193:antithrombin III-protease complex; D005344:Fibrinopeptide A; C036901:defibrotide; D000990:Antithrombin III; D005169:Factor VIII; D006493:Heparin; D010447:Peptide Hydrolases