PMID- 24254839
OWN - NLM
STAT- MEDLINE
DCOM- 20140731
LR  - 20171206
IS  - 1724-6040 (Electronic)
IS  - 0391-3988 (Linking)
VI  - 36
IP  - 10
DP  - 2013 Oct
TI  - Platelet-related hemostasis before and after hemodialysis with five different 
      anticoagulation methods.
PG  - 717-24
LID - 10.5301/ijao.5000239 [doi]
AB  - PURPOSE: To evaluate platelet-related hemostasis during hemodialysis performed 
      with five different anticoagulation methods. METHODS: 31 chronic hemodialysis 
      patients, 71% men, aged 57.5 +/- 17.4 years, participated in our prospective study. 
      Platelet function analyzer PFA -100 closure time (collagen/epinephrine -CEPI, 
      collagen/adenosine diphosphate -CADP) was measured before and after hemodialysis, 
      which was performed consecutively with five different anticoagulation methods: 
      full-dose unfractionated heparin (UFH) and low-molecular weight heparin (LMWH): 
      31 patients, regional citrate anticoagulation (RCA): 28 patients, low-dose 
      heparin: 25 patients and "heparin-free'' dialysis: 9 patients. The degree of 
      clotting in the dialysis system was graded on a 5 point scale. RESULTS: CEPI 
      (mean +/- SD, reference range 80-160 sec) before vs. after hemodialysis: UFH: 171.7 
      +/- 62.1 vs. 170.8 +/- 67.3; LMWH: 167.4 +/- 56.9 vs. 159.4 +/- 56.4; low-dose heparin: 
      175.3 +/- 69.0 vs. 183.1 +/- 
60.5; RCA: 172.6 +/- 57.4 vs. 161.6 +/- 57.0; 
      "heparin-free'': 181.7 +/- 56.8 vs. 209.0 +/- 66.5; all differences nonsignificant. 
      CADP (mean +/- SD, reference range: 68-121 sec) before vs. after hemodialysis: UFH: 
      132.0 +/- 56.6 vs.146.3 +/- 68.4; LMWH: 132.4 +/- 57,0 vs. 123.1 +/- 50.8; low-dose 
      heparin: 137.2 +/- 64.2 vs. 143.8 +/- 55.5; RCA: 140.7 +/- 48.2 vs. 132.9 +/- 48.1; 
      "heparin-free'': 137.1 +/- 68.0 vs.139.2 +/- 29.7; all differences nonsignificant. 
      Before hemodialysis procedure CEPI was increased in 51.2% and CADP in 48.4% of 
      the patients. The best dialysis system clotting score was found with UFH, LMWH 
      and RCA. CONCLUSIONS: Platelet dysfunction was demonstrated in approximately half 
      of the chronic hemodialysis patients and was not improved after hemodialysis, 
      regardless of the anticoagulation regimen used.
FAU - Knehtl, Masa
AU  - Knehtl M
AD  - Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, 
      Slovenia.
FAU - Ponikvar, Rafael
AU  - Ponikvar R
FAU - Buturovic-Ponikvar, Jadranka
AU  - Buturovic-Ponikvar J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130926
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*pharmacology
MH  - Blood Coagulation/*drug effects
MH  - Blood Platelets/*drug effects
MH  - Female
MH  - Hemostasis/*drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/*methods
MH  - Renal Insufficiency, Chronic/blood/therapy
EDAT- 2013/11/21 06:00
MHDA- 2014/08/01 06:00
CRDT- 2013/11/21 06:00
PHST- 2013/05/21 00:00 [accepted]
PHST- 2013/11/21 06:00 [entrez]
PHST- 2013/11/21 06:00 [pubmed]
PHST- 2014/08/01 06:00 [medline]
AID - 547A93A7-E912-43E1-9EE6-335DFE88B0D1 [pii]
AID - 10.5301/ijao.5000239 [doi]
PST - ppublish
SO  - Int J Artif Organs. 2013 Oct;36(10):717-24. doi: 10.5301/ijao.5000239. Epub 2013 
      Sep 26.