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Anticoagulation therapy during haemodialysis: a comparative study between two heparin regimens
Alaa Sabry1, Moammer Taha, Mamdouh Nada
1Prince Salman Center for Kidney Disease, Riyadh, Saudi Arabia. asabry20@yahoo.com
Summary
Low-molecular-weight heparin, tinzaparin sodium, offers better anticoagulation for hemodialysis than unfractionated heparin, with improved dialysis adequacy but higher short-term costs.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Low-molecular-weight heparins (LMWHs) are proposed as effective, safe, and cost-efficient anticoagulants for hemodialysis compared to unfractionated heparins (UFHs).
- LMWHs may offer benefits beyond anticoagulation, such as improved lipid profiles in uremic patients.
Purpose of the Study:
- To compare the safety, clinical efficacy, and cost-effectiveness of tinzaparin sodium versus UFH for anticoagulation in hemodialysis patients.
- To evaluate the impact of tinzaparin sodium on dialysis adequacy and lipid profiles.
Main Methods:
- A 12-month study involving 23 hemodialysis patients, divided into two 6-month stages: UFH followed by tinzaparin sodium.
- Clotting in the dialyzer and air trap was assessed visually. Dialysis adequacy (single-pool Kt/V) and lipid profiles were monitored.
Main Results:
- Tinzaparin sodium significantly reduced dialyzer and air-trap clotting compared to UFH (P = 0.001 and 0.04, respectively).
- Dialysis adequacy improved with tinzaparin sodium (1.40 +/- 0.28) versus UFH (1.23 +/- 0.28) without altering the dialysis prescription.
- No significant changes in lipid profiles were observed over 24 weeks with either anticoagulant.
Conclusions:
- Tinzaparin sodium is an effective and well-tolerated alternative to UFH for hemodialysis anticoagulation, demonstrating superior clot prevention and improved dialysis adequacy.
- While tinzaparin sodium showed benefits in efficacy, its direct cost was approximately 23% higher than UFH in the short term.
- Tinzaparin sodium did not impact lipid profiles in hemodialysis patients during the study period.
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