Prostacyclin and iloprost do not affect action of standard dose heparin on haemostatic function during haemodialysis.
The actions of prostacyclin and iloprost, as supplements to heparin therapy, were examined by measuring indices of blood coagulation and platelet activation during the first two hours of haemodialysis in six patients with stable chronic renal failure. Patients received either prostacyclin 5 ng kg-1 min-1, iloprost 2 ng kg-1 min-1 or placebo at random on three separate occasions as a supplement to standard therapy with heparin 50 I.U. kg-1 loading dose and 30 I.U. kg-1 hr-1 infusion. Neither prostacyclin nor iloprost significantly affected dialysis induced changes in whole blood platelet count and plasma concentrations of beta thromboglobulin, (beta TG) platelet factor 4 (PF4), fibrinogen and fibrinopeptide A. Thus platelet count still fell by 12 +/- 8% within 15 min of the start of dialysis, slowly returning to the initial count over the study period and plasma PF4 increased nearly 10 fold over the same time. In addition, serial measurements of KCCT failed to indicate any sparing effect of the prostanoids on this dose of heparin.
Dibble
J B
JB
Renal Unit, General Infirmary, Leeds, UK.
Kalra
P A
PA
Orchard
M A
MA
Turney
J H
JH
Davies
J A
JA
D000328:Adult; D001780:Blood Coagulation Tests; D011464:Epoprostenol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D016285:Iloprost; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D010978:Platelet Factor 4 / Q000032:analysis; D006435:Renal Dialysis; D001620:beta-Thromboglobulin / Q000032:analysis
D001620:beta-Thromboglobulin; D010978:Platelet Factor 4; D006493:Heparin; D011464:Epoprostenol; D016285:Iloprost