title: Effects of heparin and dalteparin on oxidative stress during hemodialysis in patients with end-stage renal disease.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran. nassiri@ams.ac.ir
authors.forename: Amir Ahmad
authors.initials: AA
authors.lastname: Nassiri
authors.forename: Monir Sadat
authors.initials: MS
authors.lastname: Hakemi
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Soulati
authors.forename: Mehran
authors.initials: M
authors.lastname: Marashian
authors.forename: Khosrow
authors.initials: K
authors.lastname: Rahbar
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: 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
chemical_list: 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