TY - JOUR
T1 - Haemodialysis with low MW heparin
T2 - Dosage requirements for the elimination of extracorporeal fibrin formation
AU - Lane, D. A.
AU - Ireland, Helen
AU - Flynn, Angela
AU - Anastassiades, E.
AU - Curtis, J. R.
PY - 1986
Y1 - 1986
N2 - We have performed a dose ranging study of a low MW heparin, Kabi 2165, during haemodialysis in humans (n= 16) and compared it to a dose of unfractionated commercial heparin that has already been shown to inhibit fibrin formation. Low MW heparin administered as 5000 or 10 000 anti-factor Xa units, s.c, half an hour prior to the initiation of dialysis was unable to prevent fibrin formation in the dialyser circuit. A single bolus injection of 5000 anti-factor Xa units of low M W heparin given i.v. inhibited fibrin formation, as determined by FPA generation, for up to 4 h and permitted dialysis for 6h. Such a bolus injection may be useful for short frequent dialyses. Infusion of low M W heparin in the same dosage regimen as unfractionated heparin, 5000 anti-factor Xa units bolus plus 1500 anti-factor Xa units/h, resulted in a progressive rise in heparin, caused by its longer half-life of elimination from the circulation, and almost completely suppressed both FPA generation and fibrin clot formation for 6 h dialysis. From these studies (a) we calculate that infusion of this low M W heparin at a dose of approximately 4000 anti-factor Xa units bolus plus 750 anti-factor Xa units/h should be a useful regimen that will be effective in suppressing fibrin formation during prolonged dialysis, and (b) the plasma antifactor Xa level of low M W heparin may reflect its ability to inhibit fibrin formation, although exactly comparable antifactor Xa levels of unfractionated commercial heparin and low MW heparins may not have identical inhibitory effects.
AB - We have performed a dose ranging study of a low MW heparin, Kabi 2165, during haemodialysis in humans (n= 16) and compared it to a dose of unfractionated commercial heparin that has already been shown to inhibit fibrin formation. Low MW heparin administered as 5000 or 10 000 anti-factor Xa units, s.c, half an hour prior to the initiation of dialysis was unable to prevent fibrin formation in the dialyser circuit. A single bolus injection of 5000 anti-factor Xa units of low M W heparin given i.v. inhibited fibrin formation, as determined by FPA generation, for up to 4 h and permitted dialysis for 6h. Such a bolus injection may be useful for short frequent dialyses. Infusion of low M W heparin in the same dosage regimen as unfractionated heparin, 5000 anti-factor Xa units bolus plus 1500 anti-factor Xa units/h, resulted in a progressive rise in heparin, caused by its longer half-life of elimination from the circulation, and almost completely suppressed both FPA generation and fibrin clot formation for 6 h dialysis. From these studies (a) we calculate that infusion of this low M W heparin at a dose of approximately 4000 anti-factor Xa units bolus plus 750 anti-factor Xa units/h should be a useful regimen that will be effective in suppressing fibrin formation during prolonged dialysis, and (b) the plasma antifactor Xa level of low M W heparin may reflect its ability to inhibit fibrin formation, although exactly comparable antifactor Xa levels of unfractionated commercial heparin and low MW heparins may not have identical inhibitory effects.
KW - Fibrinopeptide A
KW - Haemodialysis
KW - LMW heparin
UR - http://www.scopus.com/inward/record.url?scp=0022857695&partnerID=8YFLogxK
U2 - 10.1093/oxfordjournals.ndt.a091472
DO - 10.1093/oxfordjournals.ndt.a091472
M3 - Article
C2 - 2955253
AN - SCOPUS:0022857695
SN - 0931-0509
VL - 1
SP - 179
EP - 187
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 3
ER -