title: The rationale for the use of low molecular weight heparin for hemodialysis treatments.
abstract: Unfractionated heparin (UFH) is the most commonly used anticoagulant for hemodialysis worldwide. However, UFH comprises a series of different molecules with variable biological activity, thus risking under and over anticoagulation. As such, low molecular weight heparins (LMWHs) were developed to improve reliability. LMWHs are now established in clinical practice and have been proven to be effective in preventing extracorporeal circuit clotting, but also safer with fewer reported bleeding episodes and less heparin induced thrombocytopenia than UFH. As with UFH, most centers simply adjust the dose of LMWHs by clinical inspection of the extracorporeal circuit for thrombus, and bleeding times post-fistula needle removal. Despite potentially higher drug costs, LMWHs have become the anticoagulant of choice in Europe for routine outpatient hemodialysis sessions, due to their ease of administration and reliability of clinical effect.
authors.affiliation: UCL Center for Nephrology, University College London Medical School, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
keywords: Heparin; anticoagulation; hemodialysis