[Evaluation of the anticoagulant efficacy of Low molecular weight heparin [Fragmin] during hemodialysis in dialysis patients]

ABSTRACT

Low-molecular- weight heparin [LMWH] is a derivative of conventional heparin [standard unfractionated heparin [SUFH]]. Its beneficial effects during hemodialysis anticoagulation has caused this drug to open a new horizon for itself as an appropriate anticoagulant drug during hemodialysis. We decided to evaluate the anticoagulant efficacy of Fragmin as a low-molecular-weight heparin during hemodialysis. This experimental study was done on 35 hemodialysis patients. First blood sample was obtained for partial thromboplastin time [PTT] and predialysis BUN. Then 5000U single dose of Fragmin was injected into the arterial line of hemodialysis apparatus. After half an hour and at the end of hemodialysis session blood samples were drawn for PTT measurements. At the end of dialysis, blood samples for BUN were also drawn. For dialysis adequacy, we used Urea Reduction Rate [URR] method, and we compared the URR of LMW heparin with URR of SUF heparin by using pair T statistical analytic test. Half an hour after starting the dialysis 94% of patients had PTT equal and more than 1/8 base PIT, and at the end of four hour hemodialysis 51% had PTT equal or less than 1/4 base PTT. 49% of patients at this time had PTT more than 1/4 base PTT. Among of 49% patients there was not any need for more compression on venous sites after needle extraction at the end of session and any episode of hemorrhage was noted. We conclude that low-molecular-weight heparin can induce an appropriate anticoagulation and with single dose usage can induce an appropriate hemodialysis adequacy