PMID- 10504511
OWN - NLM
STAT- MEDLINE
DCOM- 19991202
LR  - 20220410
IS  - 0085-2538 (Print)
IS  - 0085-2538 (Linking)
VI  - 56
IP  - 4
DP  - 1999 Oct
TI  - Effect of anticoagulation on blood membrane interactions during hemodialysis.
PG  - 1578-83
AB  - BACKGROUND: Adequate anticoagulation is a precondition to prevent extracorporeal 
      blood clotting and to improve biocompatibility during hemodialysis. In this 
      study, we performed a morphologic analysis by using scanning electron microscopy 
      to compare three modes of anticoagulation-conventional unfractionated heparin 
      (UFH), low molecular weight heparin (LMWH; dalteparin sodium), or sodium citrate 
      during hemodialysis-on membrane-associated coagulation activation. METHODS: 
      Fifteen patients on regular hemodialysis therapy were investigated. Five patients 
      received UFH, five patients LMWH, and five patients sodium citrate as an 
      anticoagulant during a standardized hemodialysis protocol using a single-use 
      polysulfone capillary dialyzer. Membrane-associated clotting was evaluated using 
      a scanning electron microscope. A dialyzer clotting score was used for 
      quantitative description of coagulation activation on membrane segments. RESULTS: 
      Using UFH as an anticoagulant revealed the most pronounced cell adhesion and 
      thrombus formation and the highest dialyzer clotting score (11.5 +/- 1.3 of a 
      maximal 20 points). LMWH had a lower dialyzer clotting score than UFH (10.4 +/- 
      1.2 of 20 points). During the use of sodium citrate, a negligible thrombus 
      formation and the lowest dialyzer clotting score (1.6 +/- 0.6 of 20 points, P < 
      0.05) were observed. CONCLUSION: The results of this investigation indicate that 
      using sodium citrate as an anticoagulant during hemodialysis induces a lower 
      activation of coagulation than both conventional and fractionated heparin, which 
      might contribute to an improvement of biocompatibility of hemodialysis 
      extracorporeal circulation.
FAU - Hofbauer, R
AU  - Hofbauer R
AD  - Department of Medical and Chemical Laboratory Diagnostics, University of Vienna, 
      Austria. roland.hofbauer@akh-wien.ac.at
FAU - Moser, D
AU  - Moser D
FAU - Frass, M
AU  - Frass M
FAU - Oberbauer, R
AU  - Oberbauer R
FAU - Kaye, A D
AU  - Kaye AD
FAU - Wagner, O
AU  - Wagner O
FAU - Kapiotis, S
AU  - Kapiotis S
FAU - Druml, W
AU  - Druml W
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Kidney Int
JT  - Kidney international
JID - 0323470
RN  - 0 (Anticoagulants)
RN  - 0 (Citrates)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Membranes, Artificial)
RN  - 1Q73Q2JULR (Sodium Citrate)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*administration & dosage
MH  - Blood Coagulation/drug effects
MH  - Cell Adhesion/drug effects
MH  - Citrates/*administration & dosage
MH  - Dalteparin/*administration & dosage
MH  - Erythrocytes/ultrastructure
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Kidney Failure, Chronic/blood/*therapy
MH  - Male
MH  - Materials Testing
MH  - Membranes, Artificial
MH  - Microscopy, Electron, Scanning
MH  - Middle Aged
MH  - *Renal Dialysis
MH  - Sodium Citrate
MH  - Thrombosis/drug therapy/prevention & control
EDAT- 1999/10/03 00:00
MHDA- 1999/10/03 00:01
CRDT- 1999/10/03 00:00
PHST- 1999/10/03 00:00 [pubmed]
PHST- 1999/10/03 00:01 [medline]
PHST- 1999/10/03 00:00 [entrez]
AID - S0085-2538(15)46468-3 [pii]
AID - 10.1046/j.1523-1755.1999.00671.x [doi]
PST - ppublish
SO  - Kidney Int. 1999 Oct;56(4):1578-83. doi: 10.1046/j.1523-1755.1999.00671.x.