Hemodialysis with a dialyzer loaded with argatroban may be performed in vivo without a systemic anticoagulant.
OBJECTIVE
Anticoagulation in hemodialysis (HD) patients at high risk of bleeding remains an intractable problem. Simulating endothelial cells by releasing anticoagulant on the membrane may be a promising alternative.


METHODS
We modified a polyacrylonitrile (PAN) dialyzer by loading argatroban into its membrane and verified its anticoagulation efficiency and its influence on coagulation markers such as activated partial thromboplastin time (aPTT), D-dimer and thrombin-antithrombin complex (TAT) in an animal HD model.


RESULTS
All HD sessions with the argatroban dialyzer were completed successfully with either no or minimal fiber clotting. D-dimer was lower in the argatroban group than in the PAN group; TAT and aPTT values were similar in the two groups, which suggests better anticoagulation and a similar influence on the coagulation system.


CONCLUSIONS
HD with the argatroban dialyzer is feasible, safe and simple, and could be used in patients at high risk of bleeding.
Hunan Provincial People's Hospital, Hunan Normal University, Changsha, China.
Yixiong
Y
Zhang
Jianping
J
Ning
Pouranan
P
Veeraragoo
Yanchao
Y
Li
Siyuan
S
Dai
D000180:Acrylic Resins / Q000737:chemistry; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use*; D000990:Antithrombin III / Q000378:metabolism; D001120:Arginine / Q000031:analogs & derivatives; D001777:Blood Coagulation / Q000187:drug effects*; D004285:Dogs; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D008297:Male; D008567:Membranes, Artificial; D010314:Partial Thromboplastin Time; D010447:Peptide Hydrolases / Q000378:metabolism; D010875:Pipecolic Acids / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000379:methods*; D013449:Sulfonamides
D000180:Acrylic Resins; D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D008567:Membranes, Artificial; D010875:Pipecolic Acids; D013449:Sulfonamides; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C010504:polyacrylonitrile; D000990:Antithrombin III; D001120:Arginine; D010447:Peptide Hydrolases; C031942:argatroban