Dermatan sulfate: an alternative to unfractionated heparin for anticoagulation in hemodialysis patients.

摘要: Background: Unfractionated heparin (UFH) is the standard anticoagulant in regular dialysis treatments (RDTs), despite fact that it may induce thrombocy- topenia, dyslipidemia, allergy and osteoporosis. Der- matan sulfate (DS) selectively inhibits thrombin, does not inhibit F-Xa interfere with platelets (PLTS). Here we described an original protocol for use of DS as RDT compared its effects those UFH. Methods: In 102 patients, 7,254 RDTs were performed using anticoagulation (DS-phase) 5,707 UFH (UFH-phase). was supplied initial bo- lus (80 ± 12 mg) continuous infusion (14 7 mg/ hour). With UFH, bolus 1,475 141 IU 576 349 IU/hour. Activated par- tial thromboplastin time ratio measured at least monthly, both before (pre-RDT APTT ratio) af- ter (post-RDT sessions. 41of doses changed during study phases (stable patients). this subset, coefficient variation (CV) all pre-RDT post-RDT values calculated. Results: phases, ra- tio increased by 61% 50%, respectively, com- parison (p<0.001). PLTS count lower than phase (p<0.01). stable CV (p<0.001), which indi- cates a more predictable effect Conclusions: appeared effective an- ticoagulation RDT. It can reliably be considered alternative approach especially cases throm- bocytopenia or other adverse