engleski

What are the lowest doses of low molecular weight heparin for effective and safe hemodialysis in different subgroups of patients?

Patients on hemodialysis (HD) are prone to twoopposing hemostatic processes: a bleeding tendencyand a hypercoagulable state. Bleeding episodes inpatients on HD are common due to their underlyinguremic state, age and concomitant diseases (diabetes, bleeding disorder, vascular diseases). They maybenefit from the possibility of using less systemicanticoagulation during HD. Regional anticoagulation with citrate has beendeveloped for use as an alternative to unfractionatedheparin, particularly in patients with a high risk ofbleeding. But, for HD patients not at risk of bleeding, low molecular weight heparin (LMWH) provides asimple anticoagulation regimen. Prolonged use ofcitrate anticoagulation is complicated by concernswith calcium homeostasis and the development ofmetabolic alkalosis.

low molecular weight heparin; hemodialysis; safety

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