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Effect of vitamin E coated dialyzers on anticoagulation requirement in hemodialyzed children

Bilal Aoun1, Yuliya Janssen-Lozinska, Tim Ulinski

  • 1Department of Pediatric Nephrology, Armand Trousseau Hospital, APHP, University Pierre et Marie Curie, Paris, France.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|April 30, 2010
PubMed

Insights

Vitamin E coated (VIE) dialyzers may reduce the need for low molecular weight heparin (LMWH) in pediatric hemodialysis (HD) patients. This study found VIE membranes potentially lower anticoagulation needs, simplifying treatment and reducing bleeding risks.

Area of Science:

  • Nephrology
  • Biomaterials Science

Background:

  • Hemodialysis (HD) necessitates extracorporeal blood circulation and anticoagulation.
  • Low molecular weight heparin (LMWH) is commonly used for anticoagulation during HD.
  • Vitamin E coated (VIE) membranes are a novel approach to potentially mitigate anticoagulation requirements.

Purpose of the Study:

  • To evaluate the efficacy of VIE membranes in reducing LMWH dosage in pediatric HD patients.
  • To assess the safety and impact of VIE membranes on coagulation parameters during HD.

Main Methods:

  • Seven pediatric HD patients were enrolled and initiated on VIE dialyzers.
  • LMWH dosage was progressively reduced weekly while monitoring coagulation using a standardized score.
  • Hemoglobin, erythropoietin dose, and inflammatory markers were monitored weekly.

Main Results:

  • LMWH dosage was reduced to 30% by week three, with one patient able to discontinue anticoagulation entirely.
  • No significant clotting was observed in the first two weeks.
  • Six patients experienced mild to moderate clotting phenomena at 30% LMWH dose, indicating a limit to further reduction.

Conclusions:

  • VIE dialyzers show promise in reducing LMWH requirements for pediatric HD patients.
  • This reduction may lead to decreased bleeding complications and simplified post-dialysis hemostasis.
  • Further research is warranted to optimize LMWH reduction protocols with VIE membranes.
Abstract

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