Standard heparin versus low-molecular-weight heparin. A medium-term comparison in hemodialysis.

Sergio Stefoni, Giuseppe Cianciolo, Gabriele Donati, Luigi Colì, Gaetano La Manna, Concettina Raimondi, Vittorio Dalmastri, Valentina Orlandi, Franesca D'Addio

Research output: Contribution to journalArticlepeer-review


BACKGROUND: To compare standard heparin (SH) and low molecular weight heparin (LMWH) in terms of anticoagulation, platelet activation and lipid metabolism, we selected 54 patients who had been on 4-hour hemodialysis three times weekly for at least 12 months, without bleeding disorders or dyslipidemic diseases. 28 were on hemodialysis with Polysulfone low-flux, 26 were on hemodiafiltration with Polysulfone high-flux. All patients underwent EPO. METHODS: During the first 18 months, we administered SH 1,500 IU on starting dialysis and 1,500 +/- 500 IU in continuous intradialytic infusion per session. In the following 18 months, we administered LMWH 64.6 IU/kg on starting dialysis in a single arterious bolus. We assessed aPTT, anti-factor Xa activity, TAT and FPA, beta-TG and PF4. Blood samples were taken monthly at times 0, 30, 60, 180 and 240 min, as well as 1, 4 and 20 h after dialysis end. Predialysis cholesterol, HDL, LDL, triglycerides and lipoprotein(a) were checked monthly. RESULTS: During both LMWH and SH sessions no clotting or major bleeding complications were observed. APTT with LMWH was lower than that found with SH (p <0.001); aFXa using LMWH was higher than when using SH (p <0.001); TAT and FPA were lower in LMWH sessions (p <0.01) than in SH sessions. We also detected lower beta-TG (p <0.05) and PF4 levels (p <0.05) using LMWH than using SH. As regards lipids, we only observed a significant decrease in triglycerides after 18 months of LMWH treatment. CONCLUSIONS: Routine use of LMWH during hemodialysis affords a safe and effective alternative to SH, and causes reduced platelet activation.

Original languageEnglish
Pages (from-to)589-600
Number of pages12
Issue number3
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Nephrology


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