Use of low molecular weight heparin for hemodialysis: a short-term study

Although unfractionated heparin (UFH) is the anticoagulant commonly used for hemodialysis (HD), low molecular weight heparin (LMWH) has been found to be equally efficacious. The aim of this study was to explore the safety and efficacy of a single bolus dose of the LMWH, enoxaparin. Thirty-eight patients on maintenance HD were randomly divided into two equal groups. The mean age and body-weight of the two groups were comparable. While one group received 1 mg/kg body-weight (the manufacturer's recommended dose) of enoxaparin for three dialysis sessions of three-hours duration each, the other group received a fixed dose of 40 mg for the same number of dialyses. For the next three dialysis sessions, these doses were exchanged between the groups. In all, a total of 228 HD sessions were monitored for clotting of blood lines/dialyzers and bleeding from vascular access and other sites. The rate of complications was compared with the historical data while UFH was being used for the same patients. In general, enoxaparin was associated with fewer episodes of bleeding and clotting. Our study confirms that LMWH is of comparable efficacy to UFH and probably a lesser than recommended dose is adequate for a three-hour HD session.