LMWH Infusion as Anticoagulation for Home HD

Low-molecular Heparin Infusion as Anticoagulation for Nocturnal Home Hemodialysis

There is a lack of data in the literature about the use of low-molecular weight heparin (LMWH) as anticoagulation for nocturnal home hemodialysis (NHHD). This study aims to evaluate the efficacy and safety of LMWH, administered by infusion method, as compared to unfractionated heparin as anticoagulation for NHHD treatment.

Low-molecular weight heparin (LMWH) and unfractionated heparin (UFH) are established systemic anticoagulants for the patients who receive conventional thrice-weekly hemodialysis in absence of significant bleeding risk. For the patients who undergo nocturnal home hemodialysis (NHHD), LMWH is seldom utilized because of the need of an additional bolus injection during a long dialysis treatment, which is impractical as the patients are sleeping during hemodialysis. Moreover, there is a potential risk of LMWH accumulation due to its longer half-life. As there is a paucity of data in the literature on the use of LMWH for NHHD treatment, this trial is conducted to assess the safety and efficacy of LMWH, administered by infusion method, in this particular group of dialysis patients.

Inclusion Criteria:

• Prevalent NHHD patients who have received >1 year dialysis with unfractionated heparin as anticoagulant
• Age >= 18
• Informed consent available

Exclusion Criteria:

• History of intolerance to LMWHs during HD
• Receiving warfarin or other oral anticoagulant
• Pregnant patients