Effects of heparin and dalteparin on oxidative stress during hemodialysis in patients with end-stage renal disease.
BACKGROUND
Dialysis-induced oxidative stress is one of the mechanisms of atherosclerotic changes. Heparin, used in hemodialysis, is an anticoagulant drug with anti-inflammatory and antioxidant effects. This study was planned in order to evaluate the antioxidant effects of heparin and dalteparin (low-molecular weight heparin).


METHODS
Twenty-two patients underwent 3 hemodialysis sessions with 48-hour intervals. They underwent hemodialysis with heparin, with a bolus dose of 1000 U followed by 1000 U/h during the procedure. The second hemodialysis was done using hypertonic saline solution instead of heparin, and the third, using dalteparin, 4000 U, infused during hemodialysis. Before and after each dialysis session, we measured serum levels of total blood cholesterol, triglyceride, high- and low-density lipoprotein cholesterols and oxidized low-density lipoprotein cholesterol, in addition to total antioxidant capacity and paraoxonase 1 activity.


RESULTS
Serum concentrations of triglyceride, cholesterol, and oxidized low-density lipoprotein cholesterol, as well as paraoxonase activity and total antioxidant capacity equally increased after the three hemodialysis sessions. Heparin and daltepain increased total antioxidant capacity, but they did not change the ratio of paraoxonase 1 to high-density lipoprotein cholesterol after hemodialysis. No significant differences were found through the study between the two heparin products in their antioxidant activities.


CONCLUSIONS
Regarding these findings and considering higher price and less availability of dalteparin in comparison to conventional heparin, we recommend using conventional heparin during hemodialysis as the anticoagulant-antioxidant agent.
Nassiri
Amir Ahmad
AA
Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran. nassiri@ams.ac.ir
Hakemi
Monir Sadat
MS
Soulati
Mehrdad
M
Marashian
Mehran
M
Rahbar
Khosrow
K
Azizi
Fereidoun
F
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000191:economics; D043303:Aryldialkylphosphatase / Q000097:blood; D017985:Dalteparin / Q000008:administration & dosage* / Q000191:economics; D016527:Drug Costs; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis; D013927:Thrombosis / Q000191:economics / Q000517:prevention & control; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D000925:Anticoagulants; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; C099252:oxidized low density lipoprotein; D006493:Heparin; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human; D017985:Dalteparin