Abstract: SA-PO318
The Prevalence of Thrombocytopenia in Chronic Hemodialysis Patients Using Low-Molecular-Weight Heparin (Enoxaparin Sodium) vs. Standard Unfractionated Heparin for Hemodialysis Anticoagulation
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sobremisana, James Areja, Armed Forces of the Philippines Medical Center, Diliman, Quezon City, NCR, Philippines
- Montepio, Rafael, Armed Forces of the Philippines Medical Center, Diliman, Quezon City, NCR, Philippines
Background
Anticoagulation is essential for the prevention of blood clots in the extracorporeal circuit during hemodialysis. For decades, unfractionated heparin has been used for this purpose, however there were noted several disadvantages, hence the search for other anticoagulants with better effects have been studied. One of the effects of anticoagulation during hemodialysis is thrombocytopenia. This study aims to determine the prevalence of thrombocytopenia in chronic kidney disease patients on hemodialysis using unfractionated heparin and using low molecular weight heparin.
Methods
This study used a cross-sectional study design of hemodialysis patients comparing the prevalence of thrombocytopenia from the Enoxaparin arm with the Unfractionated Heparin arm of the study. Low molecular weight heparin was given at 0.2cc as bolus 30 minutes to 1 hour prior to hemodialysis. Unfractionated heparin was administered at 50 IU/kg bolus then at 1000 IU per hour. Thrombocytopenia was defined as decrease of 50% from baseline platelet count prior to usage or <150 x 109/L.
Results
The total number of patients recruited that was currently on hemodialysis were 161 patients. A total of 127 patients were included in the study due to exclusion criteria. The Heparin arm (n1=119 patients), and Enoxaparin arm (n2= 42 patients) were included and compared. Overall mean age of the included patients is 48.2 ± 15.2 years. Majority were males and the most common reason for dialysis was Chronic Glomerulonephritis. The age, marital status, cause and reason for HD were homogenous. Among the 127 patients, 22 patients had thrombocytopenia, 16 patients (17.2 %; 95% CI: 10.6 to 25.8) were under the heparin group, while 6 patients (17.6 %; 95% CI: 7.7 to 32.8) were under the enoxaparin group.
Conclusion
It is observed in this study that there is a high prevalence of thrombocytopenia in these study population (17.2-17.6%), compared to the known incidence of hemodialysis-related thrombocytopenia (0.2-12%). Although data is not sufficient to conclude that thrombocytopenia among these patients can be solely attributed to heparin use. Thrombocytopenia occurrence in patients who use unfractionated heparin and low-molecular weight heparin was not statistically significant between the two groups.