title: The anticoagulant activity of enoxaparin sodium during on-line hemodiafiltration and conventional hemodialysis.
abstract: To study and compare the anticoagulant activity of enoxaparin sodium during on-line hemodiafiltration (OL-HDF) and conventional hemodialysis (C-HD). Enoxaparin was administered as an anticoagulant to 21 hemodialysis patients at the beginning of a single 4-hour OL-HDF session as an intravenous bolus dose of 80 IU/kg [DOSAGE ERROR CORRECTED] On-line hemodiafiltration was performed using a high-flux polyester polymer alloy dialyzer and a total of 18 L replacement fluid (session A). One week later, the study was repeated in the same patients during a single 4-hour session of C-HD using a low-flux polysulfone dialyzer (session B). Blood samples for the measurement of Hb, blood urea and nitrogen (BUN), activated partial thromboplastin time (APTT), and anti-Xa levels were taken before each study session and 5-minute postdialysis. In 13 more patients, the same study was performed during OL-HDF using a high-flux polysulfone dialyzer (session C). No differences were found between sessions A, B, and C when predialysis values for Hb, BUN, APTT, and anti-Xa were compared. The mean postdialysis APTT and anti-Xa values were 32.5+/-3.8 seconds and 0.19+/-0.11 IU/mL, respectively, in session A, 39.0+/-5.0 seconds and 0.71+/-0.17 IU/mL in session B, and 33.8+/-3.1 seconds and 0.35+/-17 IU/mL in session C (A vs. B, P<0.0001, for both parameters, A vs. C, P<0.003 for anti-XA, and B vs. C, P<0.005, for both parameters). The anticoagulant activity of enoxaparin sodium is decreased significantly during a 4-hour OL-HDF session compared with to a similar session of C-HD. The degree of the reduction seems to depend on the dialyzer's membrane.
authors.affiliation: Renal Unit, Vas Olgas, Thessaloniki, Greece. ksob@otenet.gr
authors.forename: Kostas I
authors.initials: KI
authors.lastname: Sombolos
authors.forename: Theodora K
authors.initials: TK
authors.lastname: Fragia
authors.forename: Lazaros C
authors.initials: LC
authors.lastname: Gionanlis
authors.forename: Panagiota E
authors.initials: PE
authors.lastname: Veneti
authors.forename: Gerasimos I
authors.initials: GI
authors.lastname: Bamichas
authors.forename: Stelios K
authors.initials: SK
authors.lastname: Fragidis
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Georgoulis
authors.forename: Taïsir A
authors.initials: TA
authors.lastname: Natse
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology*; D017984:Enoxaparin / Q000494:pharmacology*; D065427:Factor Xa Inhibitors; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D006435:Renal Dialysis; D014508:Urea / Q000378:metabolism
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D014508:Urea