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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
A nadroparin infusion regimen (loading dose of 35 IU/kg, followed by 10 IU/kg per hour for 6 hours) is administered as anticoagulation during the 8-hour hemodialysis.
The individualized unfractionated heparin infusion regimen currently employed by the recruited patients in their home dialysis treatment is administered as anticoagulation during the 8-hour hemodialysis.
Alice Ho Miu Ling Nethersole Hospital
Hong Kong, Hong Kong
RECRUITINGProthrombin time
Prothrombin time is monitored in both of the LMWH and UFH arms
Time frame: Pre-dialysis; the 2nd, 4th, 6th and 8th hours of dialysis
Activated partial thromboplastin time
Activated partial thromboplastin time is monitored in both of the LMWH and UFH arms
Time frame: Pre-dialysis; the 2nd, 4th, 6th and 8th hours of dialysis
Anti-Xa level
Anti-Xa level is only monitored in the LMWH arm
Time frame: Pre-dialysis; the 2nd, 4th, 6th and 8th hours of dialysis; 24 hours after administration of LMWH
Dialyser urea and creatinine clearances
Dialyser urea and creatinine clearances are evaluated in both of the LMWH and UFH arms
Time frame: At 15 mins after starting hemodialysis and 15 mins before the end of hemodialysis
Dialyser thrombus score
Dialyser thrombus score is evaluated in both of the LMWH and UFH arms
Time frame: At the end of hemodialysis (8th hour)
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