Activation of coagulation during treatment with haemodialysis

Generation of factor XII, thrombin antithrombin complexes, prothrombin frag ment 1+2 and thrombus precursor protein has been monitored in 16 subjects d uring haemodialysis. Immediately after starting treatment, contact of blood with the negatively charged surfaces of the polyacrylnitril membrane AN-69 resulted in a 9-45% decrease in factor XII activity. Peak concentrations f or thrombin antithrombin complexes (50 to 120 mu g/L) were observed 30 min after the start of haemodialysis. Establishment of thrombus precursor prote in concentrations yielded steadily increasing results without any tendency to decrease during treatment. Determination of thrombin antithrombin comple xes is considered to establish the most sensitive short-term reacting param eter indicating activation of coagulation. A steady generation of fibrin an d fibrinogen-fibrin complexes during treatment with haemodialysis is indica ted by increasing results for thrombus precursor protein. In order to preve nt clotting during haemodialysis, an additional supplementation of anticoag ulant is needed.