Low dose of argatroban saline flushes anticoagulation in hemodialysis patients with high risk of bleeding.
BACKGROUND
Anticoagulation in hemodialysis (HD) patients with high risk of bleeding is still an intractable problem.


METHODS
A total of 80 HD sessions with high risk of bleeding were completed with either heparin-free (HF) or low dose of argatroban saline flushes (LASF) anticoagulation. Clinical clot formation in the pipeline and dialyzer was inspected to evaluate the local anticoagulation efficiency; prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer were tested to investigate the influence on the whole body coagulation system; urea reduction ratio (URR) and Kt/V were used to evaluate the efficiency of dialysis.


RESULTS
Comparing with HF, LASF showed a satisfactory efficiency in reducing the clot formation and the URR and Kt/V of it were also higher.


CONCLUSIONS
Low dose of argatroban saline flushes is a feasible and safe alternative anticoagulation protocol in HD patients with high risk of bleeding.
Yixiong
Zhang
Z
Department of Nephrology, Xiang Ya Hospital of Central South University, Chang Sha, Hu Nan Province, China.
Jianping
Ning
N
Yanchao
Li
L
Siyuan
Dai
D
D000925:Anticoagulants / Q000008:administration & dosage*; D001120:Arginine / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010875:Pipecolic Acids / Q000008:administration & dosage*; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D012965:Sodium Chloride / Q000008:administration & dosage; D013449:Sulfonamides
D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D012965:Sodium Chloride; D001120:Arginine; C031942:argatroban