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Abstract
Anticoagulation in hemodialysis (HD) patients with high risk of bleeding is still an intractable problem. A total of 80 HD sessions with high risk of bleeding were completed with either heparin-free (HF) or low dose of argatroban saline flushes (LASF) anticoagulation. Clinical clot formation in the pipeline and dialyzer was inspected to evaluate the local anticoagulation efficiency; prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer were tested to investigate the influence on the whole body coagulation system; urea reduction ratio (URR) and Kt/V were used to evaluate the efficiency of dialysis. Comparing with HF, LASF showed a satisfactory efficiency in reducing the clot formation and the URR and Kt/V of it were also higher. Low dose of argatroban saline flushes is a feasible and safe alternative anticoagulation protocol in HD patients with high risk of bleeding.
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