Anticoagulation in intermittent hemodialysis: pathways, protocols, and pitfalls

Area of Science:

• Veterinary Medicine
• Nephrology
• Pharmacology

Background:

• Extracorporeal circuit clotting is a significant complication during hemodialysis.
• Unfractionated heparin is the primary anticoagulant used in human and veterinary intermittent hemodialysis.
• Anticoagulant regimens are adjusted based on individual patient bleeding risk.

Purpose of the Study:

• To review current methods for preventing extracorporeal circuit clotting during hemodialysis.
• To highlight the role of unfractionated heparin in anticoagulant therapy.
• To discuss alternative anticoagulation strategies for high-risk patients.

Main Methods:

• Review of existing literature on hemodialysis anticoagulation.
• Analysis of unfractionated heparin protocols.
• Examination of alternative anticoagulation methods (no anticoagulation, regional anticoagulation).

Main Results:

• Unfractionated heparin is the established anticoagulant for hemodialysis.
• Dosage and type of unfractionated heparin can be modified.
• Hemodialysis can be performed with reduced or no anticoagulation in specific cases.

Conclusions:

• Unfractionated heparin remains the cornerstone of anticoagulation in hemodialysis.
• Tailoring anticoagulation strategies is crucial for patient safety.
• Alternative anticoagulation methods provide options for managing bleeding risks.