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Variations in the circulating heparin levels during maintenance hemodialysis in patients with end-stage renal disease Journal Article
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| Authors: | Kaneva, K.; Bansal, V.; Hoppensteadt, D; Cunanan, J.; Fareed, J |
| Article Title: | Variations in the circulating heparin levels during maintenance hemodialysis in patients with end-stage renal disease |
| Abstract: | Unfractionated heparin has remained the anticoagulant of choice in patients undergoing hemodialysis. However, wide variations in the heparinization responses have been observed in patients anticoagulated with this drug. The purpose of this investigation was to measure circulating heparin levels in patients with end-stage renal disease (ESRD) prior to and after maintenance hemodialysis. This study included 119 patients with ESRD undergoing maintenance hemodialysis who received heparin during dialysis. Citrated blood samples were collected prior to and immediately after the dialysis session and analyzed utilizing clot-based methods such as activated partial thromboplastin time (APTT), Heptest, and prothrombinase-induced clotting time (PiCT). Circulating anti-Xa levels, antithrombin III levels, and thrombin generation (TG) were also measured. The circulating heparin levels ranged from 0 to 1.08 IU/mL with a mean of 0.07 +/- 0.11 for the APTT and a range of 0 to 1.98 for the Heptest with a mean of 0.09 +/- 0.26 U/mL. There was no significant difference in circulating levels of heparin between pre- and post-hemodialysis samples using APTT, Heptest, and PiCT, whereas the TG and anti-Xa tests showed a statistically significant P value 0.25 U/mL of heparin, which may be related to a central catheter vascular access flushed with heparin. These findings suggest that patients on maintenance hemodialysis may accumulate a detectable amount of heparin due to the decreased renal clearance. |
| Journal Title: | Clinical Applied Thrombosis/Hemostasis |
| Volume: | 19 |
| Issue: | 4 |
| ISSN: | 1938-2723 |
| Publisher: | Unknown |
| Journal Place: | United States |
| Date Published: | 2013 |
| Start Page: | 449 |
| End Page: | 452 |
| Language: | eng |
| DOI/URL: | |
| Notes: | JID: 9508125; OTO: NOTNLM; 2013/03/04 [aheadofprint]; ppublish |
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