Background: The prerequisite of effective haemodialyzation treatment is prevention of blood coagulation in the extracorporeal circulation. The objective of the study was to evaluate the effectiveness, safety and dosage of low-molecular heparin nandroparinum calcium--Fraxiparine (Sanofi) in haemodialyzation treatment of adult patients.
Methods and results: In 29 patients (22 men, 7 women, age 54 +/- 12 years) a total of 2125 haemodialyses were made on a capillary dialyzer with a cuprophane membrane extending over 3.6 +/- 0.5 hours, incl. 84 (9 subjects) with acute and 2041 (20 subjects) with chronic irreversible renal failure. In none of the procedures complete coagulation occurred, partial coagulation of the dialyzer or the presence of fibrin deposits in the return line was found only in 148 (7%) haemodialyses, statistically significantly more frequently in acute procedures (48; 57%; p < 0.01), as compared with chronic procedures (100; 5%). The authors did not observe any haemorrhage during or after haemodialysis. The total dose of Fraxiparine needed in acute dialyses was higher (6900 +/- 2400 U.I. aXa) as compared with chronic procedures (5400 +/- 1700 U.I. aXa) the difference is however not statistically significant. In 1910 haemodialyses (89.9%) only a single bolus dose was used 5100 +/- 1400 U.I. aXa Fraxiparine (70 U.I./kg).
Conclusions: Low-molecular heparin Fraxiparine administered as a bolus makes safe and effective anticoagulation during haemodialysis possible and does not call for laboratory follow-up of the anti-Xa level. In acute haemodialyses larger doses are needed.