PMID- 32520445
OWN - NLM
STAT- MEDLINE
DCOM- 20210319
LR  - 20210319
IS  - 1542-4758 (Electronic)
IS  - 1492-7535 (Print)
IS  - 1492-7535 (Linking)
VI  - 24
IP  - 3
DP  - 2020 Jul
TI  - Effect of long-term use of unfractionated or low-molecular-weight heparin on bone 
      mineral density in maintenance hemodialysis patients.
PG  - 374-382
LID - 10.1111/hdi.12854 [doi]
AB  - INTRODUCTION: Long-term use of unfractionated heparin (UFH) or 
      low-molecular-weight heparin (LMWH) causes bone loss and osteoporosis in patients 
      not receiving hemodialysis. This study aimed to investigate the effect of UFH and 
      LMWH on bone mineral density (BMD) in patients undergoing maintenance 
      hemodialysis (MHD). METHODS: Patients undergoing MHD using UFH or LMWH as 
      anticoagulants were enrolled. BMD (in g/cm(2) ), T-score and Z-score (BMDs) were 
      measured at the lumbar spine and femur neck using dual-energy X-ray 
      absorptiometry (DXA) at baseline and 2 years later. Patient demographics and 
      clinical indices were collected. Correlation analysis was used to identify 
      significant predictors of bone loss. Multiple linear regression was used to 
      explore the relationship between heparin type and bone loss progression. 
      FINDINGS: A total of 104 patients were enrolled and completed the baseline BMD 
      test; 72 completed the test again 2 years later. Six patients were excluded 
      because they used both UFH and LMWH. Although BMD decreased in some patients in 
      the UFH group, a slight increase in the BMD was observed on an average in the 
      LMWH group after 2 years. The mean change in BMD (in g/cm(2) ) [0(-0.03,0.04) vs. 
      0.04(0,0.06), P = 0.023], T-score [0(-0.40,0.30) vs. 0.35(-0.03,0.53), P 
      = 0.038], and Z-score [0.10(-0.30,0.40) vs. 0.45(0.08,0.63), P = 0.031] in the 
      lumbar spine in the UFH group was lower than those in the LMWH group. Femur neck 
      BMD did not change significantly. In a linear regression model, after adjusting 
      for diabetes mellitus, parathyroid hormone, and serum phosphate, we did not find 
      an association between heparin substances and BMD. DISCUSSION: UFH might be 
      associated with loss of lumbar spine BMD in patients undergoing MHD.
CI  - (c) 2020 The Authors. Hemodialysis International published by Wiley Periodicals LLC 
      on behalf of International Society for Hemodialysis.
FAU - Yang, Shuo
AU  - Yang S
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
FAU - Niu, Qingyu
AU  - Niu Q
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
FAU - Gan, Liangying
AU  - Gan L
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
FAU - Zhang, Xiaobo
AU  - Zhang X
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
FAU - Tu, Lingxue
AU  - Tu L
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
FAU - Zuo, Li
AU  - Zuo L
AD  - Department of Nephrology, Peking University People's Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200610
PL  - Canada
TA  - Hemodial Int
JT  - Hemodialysis international. International Symposium on Home Hemodialysis
JID - 101093910
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Bone Density/*drug effects
MH  - Cohort Studies
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoporosis/*chemically induced
MH  - Prospective Studies
MH  - Renal Dialysis/*adverse effects
PMC - PMC7496178
OTO - NOTNLM
OT  - Hemodialysis
OT  - bone mineral density
OT  - heparin
OT  - low-molecular-weight heparin
OT  - osteoporosis
EDAT- 2020/06/11 06:00
MHDA- 2021/03/20 06:00
PMCR- 2020/09/17
CRDT- 2020/06/11 06:00
PHST- 2019/11/26 00:00 [received]
PHST- 2020/04/20 00:00 [revised]
PHST- 2020/04/30 00:00 [accepted]
PHST- 2020/06/11 06:00 [pubmed]
PHST- 2021/03/20 06:00 [medline]
PHST- 2020/06/11 06:00 [entrez]
PHST- 2020/09/17 00:00 [pmc-release]
AID - HDI12854 [pii]
AID - 10.1111/hdi.12854 [doi]
PST - ppublish
SO  - Hemodial Int. 2020 Jul;24(3):374-382. doi: 10.1111/hdi.12854. Epub 2020 Jun 10.