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The rationale for the use of low molecular weight heparin for hemodialysis treatments
Author(s) -
Davenport Andrew
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12086
Subject(s) - medicine , hemodialysis , heparin , extracorporeal , anticoagulant , intensive care medicine , anticoagulant drug , low molecular weight heparin , thrombus , surgery
Abstract Unfractionated heparin ( UFH ) is the most commonly used anticoagulant for hemodialysis worldwide. However, UFH comprises a series of different molecules with variable biological activity, thus risking under and over anticoagulation. As such, low molecular weight heparins ( LMWHs ) were developed to improve reliability. LMWHs are now established in clinical practice and have been proven to be effective in preventing extracorporeal circuit clotting, but also safer with fewer reported bleeding episodes and less heparin induced thrombocytopenia than UFH . As with UFH , most centers simply adjust the dose of LMWHs by clinical inspection of the extracorporeal circuit for thrombus, and bleeding times post‐fistula needle removal. Despite potentially higher drug costs, LMWHs have become the anticoagulant of choice in E urope for routine outpatient hemodialysis sessions, due to their ease of administration and reliability of clinical effect.