A single dose of a low molecular weight heparin fragment for anticoagulation during hemodialysis

Abstract

A low molecular heparin fragment (Fragmin, mol. wt. 4-6000 d), given as a single injection (dose 5000 anti-Xa U), was used as an anticoagulant during hemodialysis in 11 patients. In comparison, our routine heparinization procedure was used; conventional heparin was given as a bolus injection at the start and then as continuous infusion during dialysis to prolong the whole blood activated clotting time (WBACT) 125-175%. Fibrin formation, followed by visual inspection and the measuring of fibrinopeptide A and fibrin monomer concentrations were equally suppressed by the two regimens. WBACT was less prolonged with Fragmin. Anti-Xa activity above 0.39 U/ml was maintained throughout the dialyses with Fragmin. In conclusion a single dose of Fragmin gives sufficient anticoagulation for hemodialysis lasting up to 4 hours.