Comparison of Safety and Efficiency of Hemodialysis Using Heparin-bound Hemophan with those of Saline Flushing Hemodialysis and Hemodialysis Using Low Dose Heparin in Patients at Risk of Bleeding.
- Author:
Hyun Jin KIM
1
;
Young Hwan LIM
;
Min Ok KIM
;
Hyun Jeong BEAK
;
Yeon Sil DO
;
Eun Hee JANG
;
So Yeon CHOI
;
Ho Myoung YEO
;
Jung Ah KIM
;
Beom KIM
;
Bang Hoon LEE
;
Woo Heon KANG
;
Dongjin OH
;
Wooseong HUH
;
Dae Joong KIM
;
Ha Young OH
;
Yoon Goo KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center, College of Medicine, Sungkyunkwan Univesrsity, Seoul, Korea. yoongoo.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Anticoagulants;
Hemophan;
Hemodialysis
- MeSH:
Anticoagulants;
Cross-Over Studies;
Dialysis;
Flushing*;
Hemorrhage*;
Hemostasis;
Heparin*;
Humans;
Needles;
Prospective Studies;
Prothrombin Time;
Punctures;
Renal Dialysis*;
Urea
- From:Korean Journal of Nephrology
2005;24(2):246-254
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Although hemodialysis using heparin bound Hemophan (HBH-HD) has been reported to be a possible modality in patients at risk of bleeding, the efficiency and safety of HBH-HD is not certain. Therefore, we prospectively compared the safety and efficiency of HBH-HD with those of saline flushing HD (SF-HD) and HD using low dose heparin (LDH-HD) in 13 HD patients at risk of bleeding in a cross-over design. METHODS: The safety and efficiency were evaluated by measuring activated partial prothrombin time (aPTT) before and during HD, hemostasis time after needle removal, total blood compartment volume (TBCV) loss of dialyzer, urea clearance (K) and Kt/V. RESULTS: There was no difference in compression time needed to achieve hemostasis at puncture site after needle removal between HBH-HD, SF-HD and LDH-HD. During HBH-HD, there was a slight increase in aPTT at 15 min (50.6+/-4.5 sec), compared to predialysis levels (40.9+/-4.7 sec). In this cross- over study, aPTT during dialysis session was markedly higher in LDH-HD than those in HBH-HD or SF-HD (p<0.05). The loss of TBCV of the dialyzer was greater in SF-HD than HBH-HD or LDH-HD (17.4+/-1.9% vs. 12.4+/-1.4% vs. 10.1+/-1.8%). However, there was no difference in K (212.0+/-30.7 vs. 217.2+/-36.9 vs. 221.6+/- 29.5 mL/min) and Kt/V (1.22+/-0.12 vs. 1.24+/-0.16 vs. 1.26+/-0.18). CONCLUSION: We concluded that the safety and efficiency of HBH-HD are not different compared to SF-HD or LDH-HD and HBH-HD could an alternative hemodialysis method in patients at risk of bleeding.
