PMID- 2558829
OWN - NLM
STAT- MEDLINE
DCOM- 19900226
LR  - 20071115
IS  - 0301-0430 (Print)
IS  - 0301-0430 (Linking)
VI  - 32
IP  - 6
DP  - 1989 Dec
TI  - A low molecular weight heparin ("fragmin") for routine hemodialysis: a crossover 
      trial comparing three dose regimens with a standard regimen of commercial 
      unfractionated heparin.
PG  - 290-6
AB  - In 20 hemodialysis patients using mainly flat plate dialyzers, we have conducted 
      a controlled randomized crossover trial of three dose regimens of a low molecular 
      weight heparin (LMWH), "Fragmin" (Kabi 2165), in comparison with a standard dose 
      regimen of commercial unfractionated heparin (UFH) that had previously been shown 
      to provide effective anticoagulation. The aim of the present study was to find 
      the lowest dosage regimen of the LMWH which would be as effective as the standard 
      UFH regimen. The UFH regimen comprised a prime with heparinized saline, an 
      initial intravenous bolus of 5,000 international units (IU) and an infusion of 
      1,500 IU/h. The three LMWH regimens comprised a LMWH-saline prime, an infusion of 
      750 anti-factor Xa (aXa) U/h and three different bolus doses: 1) LMWH-low: 3,000 
      aXa U. 2) LMWH-medium: 4,000 aXa U. 3) LMWH-high: 5,000 aXa U. With the UFH 
      regimen, plasma heparin levels of around 1.0 IU/ml were maintained during the 
      heparin infusion, declining to 0.71 IU/ml an hour after the infusion was 
      terminated. The LMWH-medium regimen produced very similar plasma aXa levels. The 
      LMWH-high regimen also produced similar plasma aXa levels: therefore, it had no 
      advantage over the LMWH-medium regimen. The LMWH-low regimen produced 
      significantly lower levels than the other regimens during the heparin infusion 
      (0.81-0.85 aXa U/ml, p less than 0.025). Dialysis proceeded uneventfully at all 
      times and plasma levels of fibrinopeptide A (FPA) were suppressed well with all 4 
      regimens (2.77-5.74 pmol/ml) but tended to rise after the infusion was switched 
      off (5.52-8.45 pmol/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Anastassiades, E
AU  - Anastassiades E
AD  - Department of Nephrology, Charing Cross Hospital, London, UK.
FAU - Lane, D A
AU  - Lane DA
FAU - Ireland, H
AU  - Ireland H
FAU - Flynn, A
AU  - Flynn A
FAU - Curtis, J R
AU  - Curtis JR
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Germany
TA  - Clin Nephrol
JT  - Clinical nephrology
JID - 0364441
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 25422-31-5 (Fibrinopeptide A)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Clinical Protocols
MH  - Clinical Trials as Topic
MH  - Drug Administration Schedule
MH  - Female
MH  - Fibrinopeptide A/analysis
MH  - Heparin/administration & dosage/blood
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - *Renal Dialysis
EDAT- 1989/12/01 00:00
MHDA- 1989/12/01 00:01
CRDT- 1989/12/01 00:00
PHST- 1989/12/01 00:00 [pubmed]
PHST- 1989/12/01 00:01 [medline]
PHST- 1989/12/01 00:00 [entrez]
PST - ppublish
SO  - Clin Nephrol. 1989 Dec;32(6):290-6.