Bernieh B, Boobes Y, Al Hakim M R, Abouchacra S, Dastoor H
Nephrology Department, Tawam Hospital - Johns Hopkins Medicine, Al Ain, United Arab Emirates.
Blood Purif. 2009;27(3):242-5. doi: 10.1159/000199429. Epub 2009 Feb 4.
Low-molecular-weight-heparin (LMWH) is not routinely used as anticoagulant in hemodialysis (HD). The ideal dose and the safety of long-term use are not known.
A prospective three-phase interventional study. Phase 1 involved dose titration, phase 2 safety and efficacy and phase 3 routine practice.
During 7 years of the use of the LMWH enoxaparin (EN), 236 patients were treated with a total number of 60,987 HD sessions. The mean dose used during the titration phase was 0.43 +/- 0.16 mg/kg/session, which was subsequently reduced in phase 3 to 0.36 +/- 0.14 mg/kg/session. The long-term effects of EN on the platelet count and lipid profile were comparable to unfractionated heparin.
The long-term use of LMWH (EN) with a reduced dose in HD is practical and safe.
