BACKGROUND: Low-molecular-weight-heparin (LMWH) is not routinely used as anticoagulant in hemodialysis (HD). The ideal dose and the safety of long-term use are not known. METHODS: A prospective three-phase interventional study. Phase 1 involved dose titration, phase 2 safety and efficacy and phase 3 routine practice. RESULTS: During 7 years of the use of the LMWH enoxaparin (EN), 236 patients were treated with a total number of 60,987 HD sessions. The mean dose used during the titration phase was 0.43 +/- 0.16 mg/kg/session, which was subsequently reduced in phase 3 to 0.36 +/- 0.14 mg/kg/session. The long-term effects of EN on the platelet count and lipid profile were comparable to unfractionated heparin. CONCLUSION: The long-term use of LMWH (EN) with a reduced dose in HD is practical and safe. Copyright 2009 S. Karger AG, Basel.
BACKGROUND: Low-molecular-weight-heparin (LMWH) is not routinely used as anticoagulant in hemodialysis (HD). The ideal dose and the safety of long-term use are not known. METHODS: A prospective three-phase interventional study. Phase 1 involved dose titration, phase 2 safety and efficacy and phase 3 routine practice. RESULTS: During 7 years of the use of the LMWH enoxaparin (EN), 236 patients were treated with a total number of 60,987 HD sessions. The mean dose used during the titration phase was 0.43 +/- 0.16 mg/kg/session, which was subsequently reduced in phase 3 to 0.36 +/- 0.14 mg/kg/session. The long-term effects of EN on the platelet count and lipid profile were comparable to unfractionated heparin. CONCLUSION: The long-term use of LMWH (EN) with a reduced dose in HD is practical and safe. Copyright 2009 S. Karger AG, Basel.