DrugLib.com — Drug Information Portal

Rx drug information, pharmaceutical research, clinical trials, news, and more



Different effects of enoxaparin and unfractionated heparin on some thrombogenesis markers during hemodialysis: a cross-over study.

Author(s): Naumnik B, Pawlak K, Mysliwiec M

Affiliation(s): Department of Nephrology and Transplantation with Dialysis Unit, Medical University, Bialystok, Poland. bnaumnik@poczta.onet.pl

Publication date & source: 2009-02, Thromb Res., 123(4):631-6. Epub 2008 Jan 30.

Publication type: Randomized Controlled Trial

BACKGROUND: Unfractionated heparin (UFH) and low molecular weight heparin constitute fundamental anticoagulants during hemodialysis (HD). We aimed to investigate the effect of UFH and enoxaparin on plasma levels of prothrombin fragment 1+2 (PF 1+2) and thrombin/antithrombin complex (TAT) as markers of intravascular thrombogenesis during HD. METHODS: We enrolled 22 chronic HD patients, who were randomly assigned to either iv enoxaparin (n=11) or UFH (n=11) anticoagulation, and followed prospectively for 12 weeks before crossing over to the alternate therapy for further 12 weeks. Plasma levels of PF 1+2 and TAT were measured by immunoassay at the start, at 10 and 180 min of HD session after each period of evaluation. RESULTS: The baseline PF 1+2 and TAT levels were comparable under enoxaparin and UFH treatment. PF 1+2 significantly decreased during both UFH (chi(2) ANOVA=9.82, P=0.007) and enoxaparin (chi(2) ANOVA=29.40, P<10(-6)) anticoagulated HD, while over-HD TAT levels changes differed depending on the type of heparin. The switch from enoxaparin to UFH treatment was connected with a significantly higher PF 1+2 after 10 and 180 min as well as higher TAT concentration after 180 min of HD. Only during enoxaparin anticoagulated HD 34% PF 1+2 decrease and TAT levels after 180 min of HD was closely associated with heparin dosage. CONCLUSION: Single bolus of enoxaparin ensures efficient and convenient anti-thrombotic protection during HD procedure. Enoxaparin mean dose of 0.67 mg/kg, which is generally lower than manufacturer's instructions, can be recommended for over-dialytic regular use.

Page last updated: 2009-10-20

-- advertisement -- The American Red Cross
 
Home | About Us | Contact Us | Site usage policy | Privacy policy

All Rights reserved - Copyright DrugLib.com, 2006-2017