- 期刊
- OpenAccess
Use of Low-Molecular-Weight Heparin Tinzaparin in Hemodialysis: Experience from a Teaching Hospital
並列摘要
BACKGROUND: Tinzaparin is a low-molecular-weight heparin used for anticoagulation during hemodialysis (HD). It has comparable anticoagulant effects to conventional unfractionated heparin (UFH), but a longer half-Iife and lower risk of bleeding and thrombocytopenia. However, its effects on lipid profiles in patients on maintenance HD remain controversial. This study examines the efficacy and safety of tinzaparin and, in particular, its effects on scrum lipid profiles in patients undergoing maintenance HD.METHODS: Forty-eight patient s with chronic renal failure on maintenance HD for at least 3 months underwent HD using tinzaparin for 12 months. At the start of each HD, 2000 IU of tinzaparin were administered. The average duration o f dialysis sessions was 12.5 ± 0.8 hrs/week, the Kt/V was 1.9 ± 0.4, and bicarbonate dialysate was used. Adverse events and patients' laboratory data were collectedRESULTS: Forty-three patients needed only one bolus (2000 IU) and five patients required two boluses (4000 IU) of tinzaparin to achieve adequate anticoagulation. Thromhus occurred in the extracorporeal circuit in only one patient (2.08%). Bleeding at the access site occurred in four patients (8.3 %). No other side effects due to anticoagulation were observed. There was no significant change in either platelet count or hematocrit level in any patient during the 12-month study period. Serum triglyceride levels showed a decreasing trend (P=0.005), and serum cholesterol levels also showed a decreasing; trend (P=0.036) during the 12 months, but difference between serum cholesterol levels at various time points did not reach statistical significance.CONCLUSION: Tinzaparin is an effective, safe alternative to conventional UFH for anticoagulation during maintenance HD with ease of administration and potential improvement in scrum lipid profiles.