Comparing the efficacy of low molecular Weight heparin with standard unfractionated heparin in hemodialysis

الملخص EN

Background : Low Molecular Weight Heparins (LMWH) are an important new class of antithrombotic agents.

They differ from Unfractionated Heparin (UFH) in having relatively more anti-Xa activity, and greater bioavailability at low doses.

Larger half life allows us to use it as a single dose therapy.

Beneficial effect on dyslipidemia of hemodialysis also was noted.

In this research we evaluated the efficacy of LMW heparin, frogmen, on Partial Thromboplastin Time (PTT) during hemodialysis anticoagulation in comparison with UFH to recognize the rate of disturbance on PTT and its effect on dialysis adequacy.

Subject and methods : This research was done in two steps, first with commercial heparin, on 30 patients, by controlling PTT before, at first half an hour and at the end of dialysis session (three sample).

At second step with frogmen and on 35 patients, sampling were the same.

Also dialysis adequacy was measured by Urea Reduction Rate (URR) formula, and compared with dialysis adequacy of previous session.

The desired URR is over 65%, so we divided the patients into two groups of over 65% and below 65% and then we analysed the datas.

Result : Analysing the datas showed that at first half and hour of hemodialysis the result of PTT disturbance with low-molecular weight heparin was better (better anticoagulation), but at the end of dialysis there were no differences between two methods of anticoagulation.

No significant association determined by the chi-square test.

Conclusion : Comparing the dialysis adequacy with frogmen and unfractionated heparin showed no difference and as a result, frogmen can induce an equal dialysis adequacy by inducing an adequate anticoagulation.