Comparison of different routes of administration of nadroparin in hemodialysis.
OBJECTIVE
In an open, crossover, randomized study in hemodialysis patients, we investigated possible differences of the effect of the low molecular weight heparin (LMWH) nadroparin/fraxiparine in relation to the route of administration.


METHODS
The effect of nadroparin, administered by the venous line or by the arterial line after priming of the extracorporeal circuit with a part of the total dose administered, was compared with administration of the same dose by the arterial line as recommended by the manufacturer. Twelve stable, chronic hemodialysis patients were studied during 3 dialysis sessions for each treatment option. Concomitant medication was kept constant.


RESULTS
Results obtained after administration of nadroparin by the venous line were comparable to those obtained after administration by the arterial line. When a part of the dose was added to the priming solution, the anti-Xa activity, measured after 2 hours of dialysis, was somewhat lower (p = 0.09). There was also a tendency towards longer manual compression time in this group. There was no difference in hemoglobin, serum urea and creatinine before the study and at the end of each treatment option.


CONCLUSIONS
We therefore conclude that the safety and efficacy of administration of LMWH by the arterial and by the venous route are identical. There is no need for addition of a small dose of LMWH to the priming fluid.
Vanuytsel
J L
JL
Department of Nephrology and Hypertension, Stuivenberg General Hospital, Antwerp, Belgium.
Lins
R L
RL
Zachée
P
P
Mattheeussen
J
J
Hosten
S
S
Lens
S
S
Daelemans
R
R
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D015951:Factor Xa / Q000032:analysis; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D017762:Nadroparin / Q000008:administration & dosage*; D006435:Renal Dialysis; D014508:Urea / Q000097:blood
D000925:Anticoagulants; D006454:Hemoglobins; D017762:Nadroparin; D014508:Urea; D003404:Creatinine; D015951:Factor Xa