Low dose of argatroban saline flushes anticoagulation in hemodialysis patients with high risk of bleeding.

BACKGROUND

Anticoagulation in hemodialysis (HD) patients with high risk of bleeding is still an intractable problem.

METHOD

A total of 80 HD sessions with high risk of bleeding were completed with either heparin-free (HF) or low dose of argatroban saline flushes (LASF) anticoagulation. Clinical clot formation in the pipeline and dialyzer was inspected to evaluate the local anticoagulation efficiency; prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer were tested to investigate the influence on the whole body coagulation system; urea reduction ratio (URR) and Kt/V were used to evaluate the efficiency of dialysis.

RESULTS

Comparing with HF, LASF showed a satisfactory efficiency in reducing the clot formation and the URR and Kt/V of it were also higher.

CONCLUSIONS

Low dose of argatroban saline flushes is a feasible and safe alternative anticoagulation protocol in HD patients with high risk of bleeding.