Safety and efficacy anticoagulation in extracorporeal hemodialysis by simultaneous administration of low-dose prostacyclin and low molecular weight heparin.
BACKGROUND
The aim of this work is to describe an approach allowing extracorporeal hemodialysis (HD) with administration of low molecular weight heparin (LMWH) and to compare the dialyzer efficiency of this approach versus infractionated heparin (UFH) used alone.


METHODS
Low molecular weight heparin (Nadroparin, molecular weight 4500 d) administered in a single injection (dose 3075 IU AXa) plus prostacyclin (Epoprostenol sodium salt, molecular weight 375 d) by continuous infusion (3 ng/kg/min) have been used as anticoagulants during hemodialysis in 8 patients. In comparison, standard continuous heparinization by unfractionated heparin was used. Hemodialysis efficiency (dialyzer clearance for urea, creatinine, uric acid and phosphate), coagulation (activated partial thromboplastin time, antithrombin III, fibrinogen platelet count, prothrombin time) and hemodynamic parameters (blood arterial pressure and heart rate) were also evaluated during dialysis.


CONCLUSIONS
Simultaneous infusion of low molecular weight heparin plus prostacyclin allowed safe and effective anticoagulation without affecting hemodialysis efficiency.
Camici
M
M
Clinical Medical Institutes, University Hospital, Pisa.
Giordani
R
R
Morelli
E
E
Meriggioli
M
M
Balestri
P L
PL
Barsotti
G
G
Sagripanti
A
A
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D011464:Epoprostenol / Q000008:administration & dosage*; D005260:Female; D017583:Hemodiafiltration; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol