title: Hemodialysis without heparin: a randomized, controlled, crossover study of two dialysis membranes (AN69ST and polysulfone F60).
abstract: OBJECTIVE
  It has been suggested that clotting of the extracorporeal circuit during hemodialysis (HD) without heparin could be reduced by using the polyacrylonitrile AN69ST membrane. However, this has never been demonstrated in a controlled study. The objective of this study was to compare the AN69ST with a polysulfone membrane during HD without heparin in a controlled study.
  
  
  METHODS
  This was a prospective, randomized, crossover study. Each patient had two 3-h test sessions without heparin, one with polysulfone F60 (Fresenius Medical Care, Bad Homburg, Germany), and the other with AN69ST (Hospal-Gambro, Meyzieu, France). The extracorporeal circuit was pre-rinsed with saline containing unfractionated heparin. The order of the test sessions was randomized. The test sessions were performed one week apart, during the midweek day. The participants were stable HD patients without bleeding risk. The measurements were the number of sessions with partial or complete circuit clotting.
  
  
  RESULTS
  Fifty-four patients were included in the study. The number of sessions interrupted for circuit clotting was 8 (15%) with AN69ST, and 10 (19%) with polysulfone (p=0.60). Complete circuit clotting occurred in 3 (6%) sessions with the two dialyzers. Partial circuit clotting manifested by a persistent increase in venous pressure occurred in 5 (9%) sessions with AN69ST, and in 7 (13%) sessions with polysulfone (p=0.54). Mean urea reduction ratio was 62±7% for AN69ST, and 63±7% for polysulfone (p=0.62).
  
  
  CONCLUSIONS
  The AN69ST membrane did not decrease the rate of circuit clotting during HD without heparin compared to the polysulfone F60 membrane.
authors.affiliation: Centre de Néphrologie et de Transplantation Rénale, Aix-Marseille Université, Assistance Publique - Hôpitaux de Marseille, Hôpital de la Conception, Marseille - France. philippe.brunet@ap-hm.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunet
authors.forename: Julie
authors.initials: J
authors.lastname: Frances
authors.forename: Henri
authors.initials: H
authors.lastname: Vacher-Coponat
authors.forename: Dominique
authors.initials: D
authors.lastname: Jaubert
authors.forename: Gaetan
authors.initials: G
authors.lastname: Lebrun
authors.forename: Bertrand
authors.initials: B
authors.lastname: Gondouin
authors.forename: Ariane
authors.initials: A
authors.lastname: Duval
authors.forename: Yvon
authors.initials: Y
authors.lastname: Berland
mesh_terms: D000180:Acrylic Resins / Q000737:chemistry*; D000181:Acrylonitrile / Q000031:analogs & derivatives* / Q000737:chemistry; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005602:France; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011108:Polymers / Q000737:chemistry*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D013450:Sulfones / Q000737:chemistry*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; D000925:Anticoagulants; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700; C016892:AN-69; D006493:Heparin; D000181:Acrylonitrile