The role of heparin in the changes of lipid patterns during a single hemodialysis

The effects of heparin administered during dialysis on serum lipids and lipoproteins were evaluated by comparing dialysis with heparin and dialysis without heparin. Gabexate mesilate (GM), a synthetic proteinase inhibitor, was used as an anticoagulant during dialysis without heparin. In dialysis with heparin, significant increases were observed in free fatty acids (FFA), high-density lipoprotein cholesterol (HDL-C), and plasma lipolytic activity (PLA). Triglyceride (TG) was decreased reciprocally and the lipoprotein electrophoretic pattern was markedly modified. In contrast, in dialysis without heparin, no significant changes were observed in all parameters of lipid metabolism. These data suggest that dialysis induced changes in lipids are mainly caused by heparin and that acetate and glucose in dialyzate make an almost negligible contribution to abnormal lipid patterns in patients on maintenance hemodialysis.