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Effect of vitamin E coated dialyzers on anticoagulation requirement in hemodialyzed children

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Author(s): Aoun Bilal | Janssen-Lozinska Yuliya | Ulinski Tim

Journal: Saudi Journal of Kidney Diseases and Transplantation
ISSN 1319-2442

Volume: 21;
Issue: 3;
Start page: 466;
Date: 2010;
Original page

ABSTRACT
As hemodialysis (HD) requires extra corporal blood flow and the need for anti-coagulation, we evaluated the effect of vitamin E coated membranes (VIE) on the requirement of low molecular weight heparin (LMWH) in pediatric HD patients. Patients and methods: seven children and adolescents on regular hemodialysis were started on VIE and their LMWH dose was decreased every week. In order to monitor the requirement of LMWH we used a coagulation score to evaluate coagulation in the dialyzer, air trap and blood line. Other classical parameters (hemoglobin, erythropoietin dose, inflammatory markers) were monitored weekly while the pa-tients were on VIE dialyzers. LMWH dose during the 1st week was 110 IU/kg ± 18 (defined as 100%), in the 2nd week the dose was 77 IU/kg ± 12 (70%), in the 3 rd week the dose was 33 IU/kg ± 5 (30%), and in the 4 th week anticoagulation could be stopped in one patient, in the other six pa-tients further decrease was impossible given the increase of the clotting score. There was no in-crease in clotting score during week one and two. During week three (while on 30% of the initial LMWH dose) six patients showed mild to moderate clotting phenomena: mild coagulation phe-nomena in three patients and moderate clotting phenomena in three others. One patient did not show any clotting phenomena in week three and LMWH was totally stopped. In conclusion, use of VIE dialyzers may help to reduce the requirement of anticoagulation in pediatric HD patients reducing bleeding problems and simplify hemostasis after HD sessions.
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