LONG-TERM EFFECT OF LOW-MOLECULAR-WEIGHT HEPARIN ON SERUM-LIPIDS IN HYPERTRIGLYCERIDEMIC CHRONIC-HEMODIALYSIS PATIENTS

Although low-molecular-weight heparin (LMWH) has been reported to lowe r serum triglycerides and raise HDL In patients previously receiving c lassic heparin for hemodialysis by sparing lipoprotein lipase activati on, this is not universally accepted, To evaluate this effect we studi ed 14 hypertriglyceridemic patients on hemodialysis for a median of 61 months (range 6-168 months); six were males and eight females, with a median age of 54 years (range 30-78), Eight patients were on bicarbon ate and six on acetate HD, Eight were receiving EPO, All had been give n conventional heparin, 102 +/- 5.8 IU/kg, at least for the last six m onths (control period) before switching to LMWH, Mean LMWH dose was 77 +/- 3.1 IU/kg, Easting levels of total cholesterol (TC), triglyceride s (TG) and HDL were measured monthly during the control period and eve ry trimester for the next 36 months, Serum lipoproteins were measured at months 0 and 36 of the trial, TC, Lp alpha and beta showed no signi ficant change, Serum TG and Lp pre-beta dropped significantly, to almo st normal levels, EPO treatment, serum iPTH levels or dialysate buffer did not seem to influence this effect. HDL rose significantly higher in women than in men, It is concluded that LMWH substantially lowered the abnormally high serum TG and Lp pre-beta to almost normal and rais ed serum HDL in chronic hemodialysis patients.