[Clinical usefulness of heparin-coated dialyzers]

Hemodialysis procedures involve activation of the coagulation system, which creates the need for heparinization to prevent clotting in the extra- corporeal circulatory system. Heparin-based anticoagulation in dialysis, increases the risk of bleeding during and after hemodialysis procedure. Patients with active bleeding or an increased its risk should be dialyzed without heparin or with limited anticoagulation, while ensuring protection against clotting in the dialyzers and dialysis lines. The search for a reliable and comfortable manner of hemodialysis in patients at risk of bleeding did not bring long-term satisfactory results. It seems that a breakthrough in this field was the introduction of dialyzers with polyacrylonitrile membrane with adsorption capacity of heparin during their pre-rinse and then membrane dialyzers with hydrogel polyacrylonitrile heparinized during the manufacturing process. The authors evaluated the clinical usefulness of heparinized dialyzers based on 1140 Evodial hemodialysis sessions performed in 11 patients with increased risk of bleeding in the Dialysis Unit of the Department of Nephrology, University Hospital, Krakow during years 2012-2014. It has been shown that heparinized dialyzers are useful not only in patients with acute bleeding organ, but also in patients with chronic bleeding or chronic bleeding risk non responding for therapeutic methods. Their use allows the individualization of anticoagulation therapy by reducing the dose of heparin.