A New Method for the Measurement of International Normalized Ratio in Hemodialysis Patients with Heparin-Locked Tunneled Dialysis Catheters
Joint Authors
Seghers, Céline B.
Ver Elst, Kristien
Claessens, Jolien
Weekx, Steven
Vermeiren, Sigrid
Henckes, Manu
Source
International Journal of Nephrology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-12-22
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
To measure International Normalized Ratio (INR) in hemodialysis patients with tunneled dialysis catheters (TDCs), blood sampling is frequently obtained via the catheter at the start of the session.
INR measurements via finger-prick point of care testing (POCT) and via blood sampling taken from the dialysis circuit are evaluated as alternatives.
Methods.
In 14 hemodialysis patients with TDCs, treated with vitamin K antagonists (VKA), INR measurements via POCT were compared with plasma INR samples taken via the catheter at the start of dialysis and via the dialysis circuit after 30 and 60 minutes during 3 nonconsecutive dialysis sessions.
Results.
Blood samples taken at the start of dialysis at the catheter site were frequently contaminated with heparin originating from the locking solution (unfractionated heparin concentration (UFH) >1.0 IU/ml in 13.2%).
POCT INR at the start of dialysis was not different from plasma INR after 30 and 60 minutes (Wilcoxon test p=0.113, n = 37, and p=0.631, n = 36, respectively).
Moreover, there was no difference between POCT INR at the start of dialysis and POCT INR after 30 and 60 minutes (Wilcoxon test p=0.797 and p = 0.801, respectively; n = 36).
Passing and Bablok regression equation was used, y = 0.460 + 0.733x; n = 105.
Treatment decisions based on these 2 methods showed a very good overall agreement (kappa = 0.810; 95% CI: 0.732–0.889; n = 105).
Conclusions.
Measuring plasma INR via the TDC at the start of dialysis should be abandoned.
Measuring POCT INR via a finger prick at the start or even after 30 to 60 minutes is an alternative.
The most elegant alternative is to take plasma INR samples via the dialysis circuit 30 minutes or later after the start of the dialysis.
American Psychological Association (APA)
Seghers, Céline B.& Ver Elst, Kristien& Claessens, Jolien& Weekx, Steven& Vermeiren, Sigrid& Henckes, Manu. 2020. A New Method for the Measurement of International Normalized Ratio in Hemodialysis Patients with Heparin-Locked Tunneled Dialysis Catheters. International Journal of Nephrology،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1172789
Modern Language Association (MLA)
Seghers, Céline B.…[et al.]. A New Method for the Measurement of International Normalized Ratio in Hemodialysis Patients with Heparin-Locked Tunneled Dialysis Catheters. International Journal of Nephrology No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1172789
American Medical Association (AMA)
Seghers, Céline B.& Ver Elst, Kristien& Claessens, Jolien& Weekx, Steven& Vermeiren, Sigrid& Henckes, Manu. A New Method for the Measurement of International Normalized Ratio in Hemodialysis Patients with Heparin-Locked Tunneled Dialysis Catheters. International Journal of Nephrology. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1172789
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1172789