What question did this study set out to answer?

To evaluate the clinical utility, economic advantages, potential complications, and alternative strategies for unfractionated heparin anticoagulation during maintenance hemodialysis.

September 1, 2010Seminars in Dialysis

Unfractionated Heparin for Hemodialysis: Still the Best Option

Q: What is the clinical evidence from this study?

Study design: Review. Population: Maintenance hemodialysis. Intervention: Unfractionated heparin (UFH) vs. Low molecular weight heparin (LMWH).

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Key result

Unfractionated heparin remains the anticoagulant of choice for maintenance hemodialysis in the United States due to its relative ease of use, safety, and low cost.

Population

Patients undergoing maintenance hemodialysis

Comparison

Unfractionated heparin (UFH) vs Low molecular weight heparin or alternative…

Design

Review

Authors

RCRobert E. CroninVA North Texas Health Care System RRRobert F. ReillyWillamette University

Discussion

Member takes

Implication

Affirms heparin preference in US hemodialysis practice; leaves open comparative trials of alternatives in high-risk subgroups.

Key Points

To evaluate the clinical utility, economic advantages, potential complications, and alternative strategies for unfractionated heparin anticoagulation during maintenance hemodialysis.
Narrative review synthesizing anticoagulation protocols and clinical outcomes in maintenance hemodialysis across the United States and Western Europe.
Evaluated systemic unfractionated heparin against low molecular weight heparin, heparin-coated dialyzers, direct thrombin inhibitors, and regional citrate anticoagulation.
Unfractionated heparin continues as the dominant agent in the United States due to established safety, ease of administration, and favorable cost compared to unapproved alternatives like low molecular weight heparin.
Heparin-coated circuits reduce circuit clotting but still typically demand systemic anticoagulation, limiting their financial justification.
Adverse effects including heparin-induced thrombocytopenia, hyperkalemia, and hypertriglyceridemia necessitate alternative approaches such as direct thrombin inhibitors, regional citrate, or heparin-free dialysis.

Structured PICO

Population

Patients undergoing maintenance hemodialysis

Intervention

Unfractionated heparin (UFH)

Comparator

Low molecular weight heparin (LMWH) or alternative anticoagulation strategies

Unfractionated heparin remains the preferred anticoagulant for maintenance hemodialysis in the United States due to its safety, ease of use, and cost-effectiveness.

Cite This Study

Cronin et al. (2010) conducted a review in Maintenance hemodialysis. Unfractionated heparin (UFH) vs. Low molecular weight heparin (LMWH) was evaluated. Unfractionated heparin remains the anticoagulant of choice for maintenance hemodialysis in the United States due to its relative ease of use, safety, and low cost.

synapsesocial.com/papers/6a76f962df493903fd1e91a3 https://doi.org/10.1111/j.1525-139x.2010.00770.x

Topics

Anticoagulation in AF

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Unfractionated Heparin for Hemodialysis: Still the Best Option

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Unfractionated Heparin for Hemodialysis: Still the Best Option

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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