PMID- 18824874
OWN - NLM
STAT- MEDLINE
DCOM- 20090210
LR  - 20181201
IS  - 1660-2110 (Electronic)
IS  - 1660-2110 (Linking)
VI  - 110
IP  - 2
DP  - 2008
TI  - Comparison of Tinzaparin and unfractionated heparin as anticoagulation on 
      haemodialysis: equal safety, efficacy and economical parity.
PG  - c107-13
LID - 10.1159/000158561 [doi]
AB  - BACKGROUND: The European Best Practice Guidelines on anticoagulation in chronic 
      haemodialysis recommend the use of low-molecular-weight heparins (LMWH) over 
      unfractionated heparin (UFH), based on previous small-scale studies and a 
      meta-analysis which demonstrated equal efficacy of anticoagulation without an 
      increase in hemorrhagic events. METHOD: We performed a prospective single-centre 
      study where all stable patients on chronic in-hospital haemodialysis were 
      converted from UFH to Tinzaparin. Patients were monitored for 2 months before and 
      2 months after the switch. Access failures due to thrombosis, clotted circuits 
      and hemorrhagic events were recorded. RESULTS: 1,489 and 1,823 dialysis sessions 
      took place on UFH and LMWH, respectively, in 108 patients (65 male). The total 
      number of clotted circuits tended to decrease after the switch to LMWH (34 vs. 
      13) but was not statistically significant. There were four minor 
      non-access-related episodes of haemorrhage while on treatment with UFH and none 
      with Tinzaparin, and the length of bleeding time post needle removal was shorter 
      with Tinzaparin than UFH. The cost-analysis demonstrated parity of Tinzaparin 
      with UFH; using a median of 10,000 U of UFH versus 2,500 U of LMWH, each therapy 
      cost GBP 10,783 (EUR 15,942; USD 20,446) per annum. CONCLUSION: Our findings 
      suggest comparable safety and efficacy of Tinzaparin, parity of cost in 
      comparison with UFH.
CI  - Copyright 2008 S. Karger AG, Basel.
FAU - Bramham, Kate
AU  - Bramham K
AD  - South West Thames Renal Unit, St Helier Hospital, London, UK.
FAU - Varrier, Matthew
AU  - Varrier M
FAU - Asgari, Elham
AU  - Asgari E
FAU - Makanjuola, David
AU  - Makanjuola D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20080930
PL  - Switzerland
TA  - Nephron Clin Pract
JT  - Nephron. Clinical practice
JID - 101159763
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 7UQ7X4Y489 (Tinzaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/economics
MH  - Female
MH  - Health Care Costs/statistics & numerical data
MH  - Heparin/*administration & dosage/*economics
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/*economics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/adverse effects/*economics
MH  - Tinzaparin
MH  - Treatment Outcome
MH  - Venous Thrombosis/*economics/etiology/*prevention & control
EDAT- 2008/10/01 09:00
MHDA- 2009/02/12 09:00
CRDT- 2008/10/01 09:00
PHST- 2008/04/20 00:00 [received]
PHST- 2008/06/24 00:00 [accepted]
PHST- 2008/10/01 09:00 [pubmed]
PHST- 2009/02/12 09:00 [medline]
PHST- 2008/10/01 09:00 [entrez]
AID - 000158561 [pii]
AID - 10.1159/000158561 [doi]
PST - ppublish
SO  - Nephron Clin Pract. 2008;110(2):c107-13. doi: 10.1159/000158561. Epub 2008 Sep 
      30.