PMID- 16893408
OWN - NLM
STAT- MEDLINE
DCOM- 20061219
LR  - 20060808
IS  - 0894-0959 (Print)
IS  - 0894-0959 (Linking)
VI  - 19
IP  - 4
DP  - 2006 Jul-Aug
TI  - The safety of heparins in end-stage renal disease.
PG  - 305-10
AB  - In patients on chronic dialysis, unfractionated heparin (UFH) is the most 
      commonly used agent for anticoagulation of the hemodialysis extracorporeal 
      circuit, for hemodialysis catheter "locking" between dialysis treatments, and for 
      nondialysis indications such as venous thromboembolic disease, peripheral 
      vascular disease, and acute coronary artery disease. Potentially serious 
      complications of UFH, such as hemorrhage, osteoporosis, and thrombocytopenia, 
      have led to consideration of other options for anticoagulation, including low 
      molecular weight heparin (LMWH) and direct thrombin inhibitors (DTIs). LMWH can 
      be used for anticoagulation of the hemodialysis circuit, but whether this has 
      significant benefit compared to UFH remains to be proven. Because of the somewhat 
      unpredictable risk of severe bleeding complications when LMWH is used for other 
      indications in dialysis patients, UFH rather than LMWH is preferred for treatment 
      of thromboembolic disease in these patients. DTIs have been used for 
      anticoagulation in dialysis patients with heparin-induced thrombocytopenia (HIT), 
      with argatroban being the preferred agent if heparin-free hemodialysis cannot be 
      performed. UFH still remains the preferred anticoagulant in the vast majority of 
      dialysis patients requiring systemic anticoagulation and for anticoagulation of 
      the extracorporeal hemodialysis circuit.
FAU - Sonawane, Samsher
AU  - Sonawane S
AD  - Department of Medicine, Renal, Electrolyte, and Hypertension Division, Penn 
      Presbyterian Medical Center, University of Pennsylvania School of Medicine, 
      Philadelphia, Pennsylvania 19104, USA.
FAU - Kasbekar, Nishaminy
AU  - Kasbekar N
FAU - Berns, Jeffrey S
AU  - Berns JS
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Dial
JT  - Seminars in dialysis
JID - 8911629
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.5 (Thrombin)
SB  - IM
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Heparin/*administration & dosage/adverse effects/analogs & derivatives
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse effects
MH  - Humans
MH  - Kidney Failure, Chronic/therapy
MH  - *Renal Dialysis
MH  - Thrombin/*antagonists & inhibitors
MH  - Thrombosis/prevention & control
RF  - 76
EDAT- 2006/08/09 09:00
MHDA- 2006/12/21 09:00
CRDT- 2006/08/09 09:00
PHST- 2006/08/09 09:00 [pubmed]
PHST- 2006/12/21 09:00 [medline]
PHST- 2006/08/09 09:00 [entrez]
AID - SDI177 [pii]
AID - 10.1111/j.1525-139X.2006.00177.x [doi]
PST - ppublish
SO  - Semin Dial. 2006 Jul-Aug;19(4):305-10. doi: 10.1111/j.1525-139X.2006.00177.x.