title: Hemodialysis without anticoagulation.
abstract: Heparin is usually employed as an anticoagulant during routine hemodialysis. In patients at high risk of bleeding, however, use of heparin significantly increases their morbidity and, presumably, mortality. Over 1 year, we performed 156 hemodialysis procedures successfully without heparin in the transplant dialysis unit. Twenty-eight patients were included in the study; 23 patients had received renal transplants and five patients were in the mouth dental extraction, and parathyroidectomy). Only one of these patients had a coagulopathy. No dialysis procedure produced or aggravated bleeding. Conversely, a coagulopathy was not induced or worsened by dialysis without heparin. A significant complication, defined as complete clotting of the artificial kidney with or without clotting in the lines, occurred in eight dialyses (5.13% of the total) and resulted in an average blood loss of 150 ml. Partial clotting of the dialyzer did not interrupt the procedure and occurred nine times (5.8% of the total). These results compare favorably with previously documented complications from low-dose and regional heparin.
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D006435:Renal Dialysis / Q000379:methods; D012189:Retrospective Studies
chemical_list: D006493:Heparin