A CLINICAL-STUDY TO ASSESS THE EFFECT OF HEPARIN IN DIALYZER RINSING SOLUTIONS

The solution usually recommended for rinsing the blood side, which is an indispensable step in preparing a dialyzer for hemodialysis (HD), c ontains saline and heparin. The heparin used for rinsing is said to re duce the thrombogenic properties of the dialysis membrane and, hence, also the need for systemic heparinization during the whole procedure. The aim of our study was to establish whether this postulate also appl ies to polysulphone steam-sterilized dialyzers. To do so, 16 patients on long-term dialysis were randomized into two groups of eight One gro up was subsequently treated with polysulphone low-flux dialyzers (FGHP S), the other with polysulphone high-flux dialyzers (F6OS). Both group s were examined, in a crossover manner during HD using a dialyzer prev iously rinsed with 1000 mi of saline plus 2,000 IU of heparin, and dur ing HD using a dialyzer previously rinsed with 500 mi of saline withou t heparin. Except for the rinsing, HD conditions were completely ident ical. Blood obtained before HD, and at 15, 60 and 240 min of HD at the dialyzer inlet, was used to determine the activated partial thrombopl astin time (to test heparinization control), the thrombin-antithrombin III complex (ELISA, to evaluate coagulation system activation), plate let factor 4 (ELISA, a substance with antiheparin activity), and plate let count. None of the above parameters showed, at any of the collecti ng intervals, a statistically significant difference between HD with a nd without heparin with a reduced volume of rinsing solution, or betwe en HD using low- and high-flux dialyzers. ii is concluded that heparin used to rinse polysulphone dialyzers before HD has no effect on blood coagulation or on the need for heparin during the procedure.