PMID- 15797889
OWN - NLM
STAT- MEDLINE
DCOM- 20050927
LR  - 20131121
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 20
IP  - 6
DP  - 2005 Jun
TI  - A single bolus of a low molecular weight heparin to patients on haemodialysis 
      depletes lipoprotein lipase stores and retards triglyceride clearing.
PG  - 1172-9
AB  - BACKGROUND: Low molecular weight heparins (LMWH) are increasingly used during 
      haemodialysis (HD) to prevent clotting in the extracorporeal devices. It has been 
      suggested that LMWH release endothelial-bound lipoprotein lipase (LPL) less 
      efficiently than unfractionated heparin (UFH) does and thereby cause less 
      disturbance of lipid metabolism. Evidence from in vitro studies and from animal 
      experiments indicate, however, that both types of heparin preparations have the 
      same ability to release endothelial LPL, but LMWH are less effective in 
      preventing uptake and degradation of LPL in the liver. Model studies in humans 
      indicate that LMWH cause as much depletion of LPL stores and impaired lipolysis 
      of triglyceride (TG)-rich lipoproteins as UFH does. METHODS: Two anticoagulant 
      regimes based on present clinical practice were compared in nine HD patients. UFH 
      was administered as a primed infusion, whereas the LMWH (dalteparin) was given 
      only as a single bolus pre-dialysis. Blood was sampled regularly for LPL activity 
      and TG. RESULTS: LPL activity in blood was significantly lower during the 
      dialysis with dalteparin. To explore the remaining activity at the endothelium, a 
      bolus of UFH was given after 3 h of dialysis. The bolus brought out about the 
      same amount of LPL, regardless of whether UFH or dalteparin had been used during 
      dialysis. The increase in TG was significantly higher during dialysis with 
      dalteparin. CONCLUSIONS: This study indicates that a single bolus of dalteparin 
      pre-dialysis interferes with the LPL system as much as, or more than an infusion 
      of UFH does.
FAU - Nasstrom, Birgit
AU  - Nasstrom B
AD  - Department of Public Health and Clinical Medicine, Umea University, SE-901 87 
      Umea, Sweden.
FAU - Stegmayr, Bernd
AU  - Stegmayr B
FAU - Gupta, Jitendra
AU  - Gupta J
FAU - Olivecrona, Gunilla
AU  - Olivecrona G
FAU - Olivecrona, Thomas
AU  - Olivecrona T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20050329
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Anticoagulants)
RN  - 0 (Triglycerides)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.1.1.34 (Lipoprotein Lipase)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*pharmacology
MH  - Dalteparin/administration & dosage/*pharmacology
MH  - Female
MH  - Heparin/pharmacology
MH  - Humans
MH  - Lipoprotein Lipase/*blood
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis
MH  - Triglycerides/blood
EDAT- 2005/03/31 09:00
MHDA- 2005/09/28 09:00
CRDT- 2005/03/31 09:00
PHST- 2005/03/31 09:00 [pubmed]
PHST- 2005/09/28 09:00 [medline]
PHST- 2005/03/31 09:00 [entrez]
AID - gfh774 [pii]
AID - 10.1093/ndt/gfh774 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2005 Jun;20(6):1172-9. doi: 10.1093/ndt/gfh774. Epub 
      2005 Mar 29.