title: Pharmacokinetics of dalteparin during haemodialysis.
abstract: OBJECTIVE
  Usually, the appropriate dosage of low-molecular-weight heparin during haemodialysis is empirically based on the clinical effect. We studied the pharmacokinetics of dalteparin during standard haemodialysis in different groups of patients to assess the added value of measuring the anti-Xa activity for dose monitoring and adjustments.
  
  
  METHODS
  The pharmacokinetics of intravenously administered dalteparin during haemodialysis was studied in 9 patients during 27 haemodialysis sessions. Six patients received a single bolus dose of dalteparin (group 1), and 3 patients received a higher initial bolus dose of dalteparin followed by a second bolus dose after 2 h (group 2). The clinical effect was evaluated by visual inspection for clot formation in the extracorporeal circuit.
  
  
  RESULTS
  The pharmacokinetic curve suggests a zero-order process of elimination. The mean decrease in anti-Xa activity (slope) was comparable in all patients. The mean anti-Xa activity at the end of haemodialysis (Clast) was 0.15 IU/ml in group 1 and 0.60 IU/ml in group 2.
  
  
  CONCLUSIONS
  We conclude that measuring anti-Xa activity can be used to monitor the elimination of dalteparin during haemodialysis and is highly reproducible.
authors.affiliation: Atal-Medial-Medical Diagnostic Centres, Hoofddorp, The Netherlands.
authors.forename: Jeannet
authors.initials: J
authors.lastname: Nigten
authors.forename: Karina A
authors.initials: KA
authors.lastname: de Groot
authors.forename: Diana C
authors.initials: DC
authors.lastname: Grootendorst
authors.forename: Stijn L W
authors.initials: SL
authors.lastname: Koolen
authors.forename: Martien H
authors.initials: MH
authors.lastname: Herruer
authors.forename: Niels H
authors.initials: NH
authors.lastname: Schut
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D017985:Dalteparin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000925:Anticoagulants; D017985:Dalteparin