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Related Experiment Videos

Is heparin therapy necessary in CAPD peritonitis?

C Nadig1, U Binswanger, A von Felten

  • 1Department of Nephrology, University Hospital, Zurich, Switzerland.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|November 14, 1997
PubMed
Summary

Routine heparin therapy for continuous ambulatory peritoneal dialysis (CAPD) peritonitis is not necessary. Low D-dimer levels in CAPD dialysate during peritonitis may indicate a need for heparinization in rare cases.

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Area of Science:

  • Nephrology
  • Peritoneal Dialysis
  • Inflammation Research

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) peritonitis management often includes heparin therapy.
  • Hospitalization for heparin therapy in CAPD peritonitis is costly.
  • Evidence supporting the routine use of heparin in CAPD peritonitis is lacking.

Purpose of the Study:

  • To evaluate the necessity of routine heparin therapy in patients with CAPD peritonitis.
  • To investigate the role of coagulation and fibrinolysis markers in CAPD peritonitis.

Main Methods:

  • Analysis of 194 peritoneal dialysate samples from 17 patients over 24 months.
  • Categorization of samples into no, mild, and severe peritonitis groups based on leukocyte counts.
  • Measurement of leukocytes, total protein, thrombin-antithrombin III (TAT) complexes, D-dimers, and plasminogen activator inhibitor 1 (PAI-1).

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Main Results:

  • Dialysate protein, TAT-complex, and D-dimer concentrations increased with peritonitis severity.
  • A strong correlation was observed between TAT-complex and D-dimer concentrations.
  • In a subset of patients with peritonitis, high PAI-1 and low D-dimer levels indicated blocked fibrinolysis.

Conclusions:

  • Routine intraperitoneal heparin administration is not required for CAPD peritonitis.
  • Rare cases of peritonitis with blocked fibrinolysis (high PAI-1, low D-dimer) may benefit from heparinization.
  • Low D-dimer levels in CAPD dialysate during peritonitis can identify patients who might require heparin therapy.