Haemodialysis with low MW heparin: Dosage requirements for the elimination of extracorporeal fibrin formation

D. A. Lane, Helen Ireland, Angela Flynn, E. Anastassiades, J. R. Curtis

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)179-187
Number of pages9
JournalNephrology Dialysis Transplantation
Volume1
Issue number3
DOIs
Publication statusPublished - 1986

Keywords

  • Fibrinopeptide A
  • Haemodialysis
  • LMW heparin

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