Effects of low molecular weight heparin sodium and sodium citrate on hemodialysis patients at high risk of bleeding: a comparative study / 中国输血杂志

ABSTRACT

【Objective】 To compare the therapeutic effects of low molecular weight heparin sodium and sodium citrate on hemodialysis(HD) patients at high risk of bleeding. 【Method】 A total of 96 patients at high risk of bleeding on maintenance hemodialysis from May 2018 to May 2020 were enrolled and divided randomly into control group(n=48) and observation group(n=48). Patients in control group received systemic anticoagulation with heparin, and patients in observation group adopted regional citrate anticoagulation of in vitro dialyzer. The indexes of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), D-dimer, service time of filters and the dialysis efficiency, as well as the complication occurrences of clotting events, bleeding, metabolic alkalosis and hypocalcaemia were compared between the two groups. 【Results】 No significant difference was found in coagulation indicators (ACT, PT, Fg, APPT and D-dimer) before and after hemodialysis in observation group(P>0.05), but those in control group were prolonged significantly (P0.05). The incidence of filter clotting (0.0%), dialyzer pipeline clotting (0.0%) and bleeding (2.1%) in observation group were less than those in control group (8.3%, 6.2%, 14.6%, respectively) (P0.05). 【Conclusion】 Regional anticoagulation with citric acid in vitro is safe for patients on maintenance hemodialysis at high risk of bleeding, and can greatly prolong service time of filters, reduce bleeding and thrombocytopenia rates, bring less effects to coagulation function in vivo.