Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (44): 8321-8324.doi: 10.3969/j.issn.1673-8225.2011.44.038

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Two different anticoagulant protocols for treatment of combined-type artificial kidney

Xing Li, Wang Pei-yu, Cai Wen-li, Wang Ning, Li Hai-xia, Wang Yan-fang   

  1. Room of Blood Purification, Department of Nephropathy and Organ Transplantation, Zhengzhou People’s Hospital, Zhengzhou  450003, Henan Province, China
  • Received:2011-07-26 Revised:2011-09-16 Online:2011-10-29 Published:2011-10-29
  • About author:Xing Li★, Master, Attending physician, Room of Blood Purification, Department of Nephropathy and Organ Transplantation, Zhengzhou People’s Hospital, Zhengzhou 450003, Henan Province, China xingli0809@yahoo.cn

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Abstract:

BACKGROUND: Combined-type artificial kidney can completely get rid of various toxins in uremia patients, prevent and treat long-term complications caused by dialysis. But dialyzer and perfusion instrument blood coagulation trouble physicians and patients.
OBJECTIVE: To investigate the anticoagulant effects and safety of two different anticoagulant protocols in treatment of chronic renal failure in combined-type artificial kidney.
METHODS: Heparin sodium and low molecular heparin sodium was used for 4-week anticoagulation in chronic renal failure patients who received combined-type artificial kidney (hemoperfusion+hemodialysis) at the amount of 1.5-2.0 times of original anticoagulant protocols. Anticoagulant effects, hemorrhage, prothrombin time, partial thromboplastin time, thrombin time, blood platelet and hemoglobin levels before treatment, 4 and 8 weeks after treatment were compared between two different anticoagulant drugs.
RESULTS AND CONCLUSION: When heparin sodium was used, grade 1 blood coagulation appeared in two cases and grade 2 blood coagulation in one case. When low molecular heparin sodium was used, grade 1 blood coagulation appeared in three cases and grade 2 blood coagulation in two cases. Grade 3 blood coagulation was not observed when heparin sodium or low molecular heparin sodium was used. When heparin sodium was used, grade 1 hemorrhage was observed in 12 cases and grade 3 hemorrhage in three cases. When low molecular heparin sodium was used, grade 1 hemorrhage was observed in two cases and grade 2 hemorrhage in one case. After heparin sodium application, blood platelets were reduced, partial thromboplastin time was prolonged, and there was no significant difference compared with before treatment. There was no significant difference in each index between before and after low molecular heparin sodium application (P > 0.05). These results showed that in combined-type artificial kidney treatment in chronic renal failure patients, low molecular heparin sodium and heparin sodium show similar anticoagulant effects, and low molecular heparin sodium exhibits fewer complications.

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