Dose and lipid lowering effect of tinzaparin sodium: a single center experience

The administration of an anticoagulant is essential to prevent clotting of blood in the extra corporeal circuit during a hemodialysis (HD) session. Unfractionated heparin (UFH) has been used for this purpose over many decades with satisfactory results. However, UFH has many unwanted side effects such as risk of bleeding, thrombocytopenia, paradoxical thrombosis as well as disturbances of blood lipids. Over the last few years, low molecular weight heparin (LMWH.) has been introduced in medical practice. We performed this prospective study at the Jeddah Kidney Center, Jeddah, Saudi Arabia to evaluate the efficacy of LMWH. We compared the changes in lipid profile during the period of administration of LMWH with the changes observed during the administration of UFH. A total of 30 patients were involved in this prospective study. During the first part of the study, which was carried out for 12 weeks, all the study patients received UFH as anticoagulant during the HD sessions. During the second part of the study, which was conducted over the subsequent 12 weeks, the same patients were given LMWH as anticoagulant during the HD sessions. During the HD sessions using Tinzaparin, no significant problems were observed and HD was performed efficiently. The total cholesterol level was reduced during the administration of LMWH while the triglyceride levels showed a rise during this period. Our study suggests that LMWH is a safe and effective substitute for UFH for anticoagulation during HD sessions. Studies on larger cohorts and for longer periods of time are required to validate our observation.