Impact of membrane choice and blood flow pattern on coagulation and heparin requirement--potential consequences on lipid concentrations

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
H SperschneiderG Stein

Abstract

We reasoned that procoagulant activity, and by implication heparin requirement, during haemodialysis are influenced, amongst other factors, by the type of membranes and the geometry of the blood line system. In addition, there are indications that heparin has dose-dependent effects on the lipid status of chronic haemodialysis patients. In a parallel group design we compared patients treated with cuprophane (CU) and polycarbonate-polyether (PC-PE) plate dialysers. In both groups, blood line geometry was varied by including in a first phase and omitting in a second phase drip chambers in the arterial blood line. End-points were changes in coagulation parameters, i.e. thrombin-antithrombin III complex (TAT), plasmin-anti-plasmin complex (PAP), and prothrombin fragment (F1 + 2) concentrations measured by sandwich ELISA. Subsequently all patients were switched to PC-PE dialysers for 6 months and the heparin dose was reduced in a stepwise fashion. Lipid levels and coagulation parameters were monitored. Finally, in an ancillary study, the correlation between heparin dose and LDL/HDL ratio was assessed in patients chronically exposed to PC-PE membranes and low doses of heparin. Post-dialytic concentrations of coagulation and fibrinolys...Continue Reading

Citations

May 3, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Pieter EvenepoelYves Vanrenterghem
Apr 1, 2003·Hemodialysis International·Andrew Davenport
Dec 7, 2011·Hemodialysis International·Andrew Davenport
Dec 27, 2011·The International Journal of Artificial Organs·Philippe BrunetYvon Berland
Nov 25, 2004·The International Journal of Artificial Organs·V Stefanovic, M Milojkovic

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