Comparative study of the use of argatroban, heparin anticoagulant and heparin free dialysis in hemodialysis patients

Abstract

Objective Explore the clinical efficacy and safety of new anticoagulant agaroban in hemodialysis patients. Methods 120 long-term hemodialysis patients were divided into regular treatment group and high risk of bleeding group.High risk of bleeding group was divided into no heparin treatment group and argatroban treatment group.Regular treatment group was divided into heparin treatment group and low molecular heparin treatment group(30 cases of patients in each group). APTT and ACT were tested respectively before the blood dialysis, blood dialysis treatment for 2 hours, and after off-line dialysis machine. PLT and H-PF4 antibody were tested in all group after blood dialysis treatment for 2 months, while observe adverse reaction. Results Among argatroban and ordinary heparin and low molecular heparin treatment group APTT and ACT changes were no significant differences before dialysis and after 2 hours dialysis, (P>0.05). At the end of 2 hours dialysis, the value of APTT and ACT were different in arterial catheters compared venous (P<0.01). APTT and ACT were significantly different in argatroban group compared ordinary heparin and low molecular heparin treatment group after off-line dialysis machine (P<0.01). The coagulation of dialyzer without heparin group was significantly different from that of heparin group, low molecular weight heparin group and argatroban group (P<0.05). There was no significant difference in the dialyzer blood coagulation in the argatroban group compared with the heparin and low molecular weight heparin treatment groups. There was no difference in platelet count between the two groups after 2 months, while 1 case of H-PF4 antibody was detected respectively in heparin group and low molecular weight heparin group. Conclusions The anticoagulant effect of argatroban in hemodialysis was similar as heparin and low molecular weight heparin. Argatroban has less effect on the coagulation state in vivo, less bleeding complications, and is safer for clinical use. Key words: Argatroban; Heparin; Low molecular heparin; Heparin free dialysis; Anticoagulant; Hemodialysis