Long-term use of low-molecular-weight heparin in hemodialysis patients: a 7-year experience.
BACKGROUND
Low-molecular-weight-heparin (LMWH) is not routinely used as anticoagulant in hemodialysis (HD). The ideal dose and the safety of long-term use are not known.


METHODS
A prospective three-phase interventional study. Phase 1 involved dose titration, phase 2 safety and efficacy and phase 3 routine practice.


RESULTS
During 7 years of the use of the LMWH enoxaparin (EN), 236 patients were treated with a total number of 60,987 HD sessions. The mean dose used during the titration phase was 0.43 +/- 0.16 mg/kg/session, which was subsequently reduced in phase 3 to 0.36 +/- 0.14 mg/kg/session. The long-term effects of EN on the platelet count and lipid profile were comparable to unfractionated heparin.


CONCLUSIONS
The long-term use of LMWH (EN) with a reduced dose in HD is practical and safe.
Bernieh
B
B
Nephrology Department, Tawam Hospital - Johns Hopkins Medicine, Al Ain, United Arab Emirates. bassambernieh@hotmail.com
Boobes
Y
Y
Al Hakim
M R
MR
Abouchacra
S
S
Dastoor
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*
D017984:Enoxaparin