Key result
Anti-Xa activity <0.88 IU/mL at 0.5 hours and <0.35 IU/mL at 4 hours were associated with significantly higher odds of extracorporeal circuit clotting during haemodialysis.
Why the study?
The study was conducted to evaluate the relationship between anti-Xa activity and anticoagulant effect, and to ascertain whether accumulation of low-molecular-weight heparins occurs during haemodialysis.
Does anti-Xa activity predict extracorporeal circuit clotting and LMWH accumulation in patients undergoing haemodialysis?
Observational (n=90)
No
Does anti-Xa activity predict extracorporeal circuit clotting and LMWH accumulation in patients undergoing haemodialysis?
Answers are grounded in this paper and cite their sources.
Anti-Xa activity measurement can be used to adjust LMWH dosage and predict anticoagulant effect during haemodialysis without evidence of accumulation over three sessions.
AIM: Evaluate the relationship between anti-Xa activity and anticoagulant effect, and ascertain whether accumulation of low-molecular-weight heparins (LMWH) occurs during haemodialysis. METHODS: There was an observational, single-centre study among participants who received the LMWH dalteparin, enoxaparin or nadroparin. A standard haemodialysis session lasted 4 hours. All included participants had anti-Xa activity measures at 0.5 and 4 hours. Extracorporeal circuit (ECC) clotting was evaluated by visual inspection of the haemodialyser and bubble trap after each haemodialysis session. The same person was tested at three consecutive haemodialysis sessions. RESULTS: Overall, 90 participants were enrolled and 259 haemodialysis sessions assessed. There was no significant difference in the mean anti-Xa activity at 0.5 and 4 hours for three consecutive sessions, so LMWH accumulation did not occur. There were 69 (26.6%) sessions in which, ECC clotting was visible. Compared with the group where circuit clotting did not occur, the LMWH dose and anti-Xa activity in the group where circuit clotting occurred were significantly lower. At 0.5 hour, anti-Xa <0.88 IU/mL had significantly higher odds of ECC clotting than that at ≥0.88 IU/mL. At 4 hours, anti-Xa <0.35 IU/mL had significantly higher odds of ECC clotting than that at ≥0.35 IU/mL. CONCLUSION: We found that over three haemodialysis sessions, no significant accumulation of LMWH was evident in subjects receiving a LMWH dose of between 2000 and 5000 IU for regular. Anti-Xa activity measurement can be used to adjust the dosage of LMWH and predict the anticoagulant effect during haemodialysis.
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Tao et al. (2020) conducted an observational in Haemodialysis (n=90). Anti-Xa activity <0.88 IU/mL at 0.5 hours or <0.35 IU/mL at 4 hours vs. Anti-Xa activity ≥0.88 IU/mL at 0.5 hours or ≥0.35 IU/mL at 4 hours was evaluated on Extracorporeal circuit (ECC) clotting. Anti-Xa activity <0.88 IU/mL at 0.5 hours and <0.35 IU/mL at 4 hours were associated with significantly higher odds of extracorporeal circuit clotting during haemodialysis.
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