PMID- 11510916
OWN - NLM
STAT- MEDLINE
DCOM- 20011220
LR  - 20171206
IS  - 0391-3988 (Print)
IS  - 0391-3988 (Linking)
VI  - 24
IP  - 7
DP  - 2001 Jul
TI  - Effect of low molecular weight heparin on bone metabolism and hyperlipidemia in 
      patients on maintenance hemodialysis.
PG  - 447-55
AB  - The effect of low molecular weight heparin (LMWH) on serum lipid profile in 
      hemodialysis remains controversial and its effect on bone metabolism has not been 
      studied. A crossover study was conducted in 40 patients on stable hemodialysis 
      using unfractionated heparin (UFH) for more than 24 months. These patients were 
      then treated with a LMWH (nadroparin-Ca) for 8 months during hemodialysis and 
      subsequently switched back to UFH for 12 months. Serum lipid profile, biochemical 
      markers for bone metabolism, and bone densitometry (BMD) were monitored at 
      four-month intervals while all medications remained unchanged. Cholesterol (TC), 
      triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), lipoprotein(a) 
      (Lp(a)), apolipoprotein B (Apo B) were raised in 35%, 29%, 12%, 24% and 24% of 
      patients respectively. High-density lipoprotein-cholesterol (HDL-C) and 
      apolipoprotein A1 (Apo A-1) were reduced in 47% and 9% of patients. Bone-specific 
      alkaline phosphatase (BALP) and intact osteocalcin (OSC), both reflecting 
      osteoblastic activity, were raised in 65% and 94% of patients. Tartrate-resistant 
      acid phosphatase (TRACP) reflecting osteoclastic activity and parathyroid hormone 
      (PTH) were elevated in 35% and 88% of patients. Following LMWH treatment, TC, Tg, 
      Lp(a) and Apo B were reduced by 7%, 30%, 21% and 10% respectively (p<0.05 or 
      <0.01) while Apo A-1 were raised by 7% (p<0.01). Simultaneously, TRACP was 
      reduced by 13% (p<0.05). These biochemical changes were detected soon after 4 
      months of LMWH administration. Although BMD values in our patients were lower 
      than those of age-matched normal subjects, significant changes were not observed 
      with LMWH treatment. After switching back to UFH for hemodialysis, these 
      biochemical indices reverted to previous values during UFH treatment with a 
      significant higher level in TC and Apo B while serum Apo A-1 remained elevated. 
      Our study suggests LMWH may partially alleviate hyperlipidemia and, perhaps, 
      osteoporosis associated with UFH administration in patients on maintenance 
      hemodialysis.
FAU - Lai, K N
AU  - Lai KN
AD  - Department of Medicine, University of Hong Kong, Queen Mary Hospital, China. 
      knlai@hkucc.hku.hk
FAU - Ho, K
AU  - Ho K
FAU - Cheung, R C
AU  - Cheung RC
FAU - Lit, L C
AU  - Lit LC
FAU - Lee, S K
AU  - Lee SK
FAU - Fung, K S
AU  - Fung KS
FAU - Tong, M K
AU  - Tong MK
FAU - Lam, C W
AU  - Lam CW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
RN  - 0 (Anticoagulants)
RN  - 0 (Biomarkers)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*pharmacology/therapeutic use
MH  - Biomarkers/blood
MH  - Bone Density/*drug effects
MH  - Bone and Bones/*drug effects/*metabolism
MH  - Cross-Over Studies
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*pharmacology/therapeutic use
MH  - Humans
MH  - Hyperlipidemias/blood/*metabolism
MH  - Male
MH  - Middle Aged
MH  - *Renal Dialysis
MH  - Single-Blind Method
EDAT- 2001/08/21 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/08/21 10:00
PHST- 2001/08/21 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/08/21 10:00 [entrez]
PST - ppublish
SO  - Int J Artif Organs. 2001 Jul;24(7):447-55.