DIFFERENT TYPES OF HEPARIN IN HEMODIALYSIS - LONG-TERM EFFECTS ON POSTHEPARIN LIPASES

Several long-term studies of haemodialysis patients have shown improve d serum lipid profile associated with treatment with low molecular wei ght heparin (LMWH) as compared with unfractionated heparin (UH). This has been attributed to the fact that LMWH produces a less marked acute lipolytic response than UH. However, the information on the differenc es in long-term effects on tissue releasable lipases is limited. Post- heparin plasma lipase activities were measured at 6, 24 and 48 h after pre-dialysis heparin injections in seven patients on chronic haemodia lysis during treatment with UH; these measurements were then repeated 2 and 6 months after treatment was switched to LMWH. The curves plotte d from the results can be assumed to reflect the interdialytic lipolyt ic potential. In the case of lipoprotein lipase this was unchanged 2 m onths after treatment was switched from UH to LMWH but increased by a mean of 47% after 6 months. In the case of hepatic lipase there was no change in the interdialytic lipolytic potential. Thus, there was a sl ow increase in tissue releasable lipoprotein lipase stores after treat ment was switched from UH to LMWH, probably reflecting a smaller loss of lipoprotein lipase after each LMWH injection. Hepatic lipase, in co ntrast, was not affected by the type of anticoagulation.