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Anticoagulation for people receiving long-term haemodialysis
Patrizia Natale1,2,3, Suetonia C Palmer4, Marinella Ruospo3
1Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy.
The Cochrane Database of Systematic Reviews
|January 8, 2024
Summary
Anticoagulation for haemodialysis (HD) has uncertain risks for circuit clotting and bleeding. Regional citrate may reduce minor bleeding, but evidence quality is low for guiding clinical decisions.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Trials
Background:
- Haemodialysis (HD) necessitates safe anticoagulation to prevent circuit clotting and bleeding complications.
- Low molecular weight heparin (LMWH) offers potential advantages over unfractionated heparin (UFH) but carries risks of accumulation and bleeding.
Conclusions:
- Comparative risks of UFH and LMWH for circuit thrombosis and bleeding remain uncertain.
- Regional citrate may reduce minor bleeding, but its effects on major bleeding and thrombosis are unreported.
- Low certainty evidence limits clinical decision-making for HD anticoagulation strategies.
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