ANTICOAGULATION DURING HEMODIALYSIS WITH A SINGLE-DOSE OF LOW-MOLECULAR-WEIGHT HEPARIN

The aim of this work was to compare the benefits and problems of low m olecular weight heparin use in chromic hemodialysis, compared to conve ntional heparin. We studied 35 patients that received low molecular we ight heparin (Enoxaparine, molecular weight 400) during 115 consecutiv e hemodialysis procedures and conventional heparin during the subseque nt 35 procedures. We assessed the heparin dose, partial thromoplastin time before dialysis and at 3 and 120 min during the procedure, arteri o-venous fistula compression time, clot formation in the circuit and r esidual volume of filters. Medium total dose of conventional heparin w as 6289 U (range 3000-10000) compared to 5555 U (range 2000-8000) of l ow molecular weight heparin. When the dose was calculated per kg of bo dy weight, it was lower for low molecular weight heparin than for conv entional heparin (87.8 U (range 33-100) vs 100 U (range 50-176)). Part ial thromboplastin time achieved was lower with low molecular weight h eparin, compared with conventional heparin, at 3(64.26 vs 125.2 sec) a nd 120 min (39.1 vs 84.45 sec). Clot formation, arteriovenous fistula compression time and residual volume of filters were similar for both types of heparin. It is concluded that a single dose of low molecular weight heparin simplifies anticoagulation during hemodialysis, modifie s less the partial thromboplastin time and does not alter filter re-ut ilization.