DOSE TITRATION OF LOW-MOLECULAR-WEIGHT HEPARIN IN PATIENTS UNDERGOINGCHRONIC-HEMODIALYSIS

Low molecular weight (1 mw) heparins may be used in haemodialysis to p revent clotting in the extracorporal circulation. In a clinical pilot trial, eight patients undergoing chronic haemodialysis were treated fo r six months with a 1 mw heparin. For each patient the dosage was titr ated as to avoid thrombosis in the dialysis system. The doses required ranged interindividually between 1,083 and 4,500 aPTT units (mean: 2, 780 units) but were intraindividually constant throughout the study pe riod. Clinical efficacy was associated with antifactor Xa activities o f 0.4 +/- 0.1 U/ml during dialysis. Compared with the last six months prior to study entry, the patients needed 12 percent less erythrocyte concentrates. No side effects of the 1 mw heparin were observed.