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Vol. 32, No. 3, 2002
Issue release date: May–June 2002 (October 2002)
Pathophysiol Haemost Thromb 2002;32:107–110

Effect of Low-Molecular-Weight Heparin on Potassium Homeostasis

Abdel-Raheem M.M.a · Potti A.a,b · Tadros S.a · Koka V.a · Hanekom D.a · Fraiman G.b · Danielson B.D.c
aDepartment of Medicine, University of North Dakota School of Medicine, bDepartment of Medicine, Division of Hematology, Veterans’ Affairs Medical Center, and cDepartment of Medicine, Division of Nephrology, Veterans’ Affairs Medical Center, Fargo, N. Dak., USA
email Corresponding Author

 goto top of outline Key Words

  • Transtubular potassium gradient
  • Low-molecular-weight heparin
  • Adverse effect
  • Hyperkalemia

 goto top of outline Abstract

Background: Low-molecular-weight heparins (LMWHs) are being preferred to unfractionated heparin (UFH) because of their superior convenience and a comparable or slightly better toxicity profile. Whether LMWH has an inhibitory effect on aldosterone that causes hyperkalemia is yet uncertain. Methods: Twenty-eight patients (all male; mean age: 70 years, range 52–87 years) placed on LMWH therapy (40 mg subcutaneously every 12 h) for deep venous thrombosis prophylaxis after an operation were included in the study. Transtubular potassium concentration gradient (TTKG) was calculated 1 day prior to LMWH therapy and again after 4 days of treatment. Of the 28 patients enrolled in the study, we were able to calculate the TTKG in only 19 patients: 9 had a urinary osmolarity (either before or after LMWH therapy) less than the serum osmolarity, making the TTKG calculation unreliable. The Wilcoxon signed-rank test was used to analyze differences in the median serum potassium levels and TTKG before and after LMWH therapy. Results: All patients had adequate renal function (creatinine clearance >90 ml/min). Mean (± SD) serum potassium concentration before LMWH was 4.25 (± 0.40) mmol/dl. It increased to 4.35 (± 0.41) mmol/dl after initiating LMWH therapy (p = 0.09). Similarly, the mean (± SD) TKKG calculated was 5.52 (± 2.33) before and 5.97 (± 3.06) after 4 days of LMWH (p = 0.54). Conclusions: Unlike UFH, LMWH (Lovenox®) in doses used for postoperative prophylaxis against deep venous thrombosis does not seem to have a significant effect on potassium homeostasis.

Copyright © 2002 S. Karger AG, Basel

 goto top of outline References
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    External Resources

  3. Halperin ML, Goldstein MB: Fluid, Electrolyte, and Acid-Base Physiology: A Problem-Based Approach, ed 3.Philadelphia, Saunders, 1998.
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  5. DuBose TD Jr: Hyperkalemic hyperchloremic metabolic acidosis: Pathophysiologic insights. Kidney Int 1997;51:591–602.
  6. Canova CR, Fischler MP, Reinhart WH: Effect of low-molecular-weight heparin on serum potassium. Lancet 1997;349:1447–1448.

    External Resources

  7. Levesque H, Verdier S, Cailleux N, et al: Low molecular weight heparins and hypoaldosteronism. BMJ 1990;300:1437–1438.

    External Resources

  8. Wong KS, Kay R: Low-molecular-weight heparin and serum potassium. Lancet 1997;350:664.
  9. Marcelli JM, Lalau JD, Abourachid H, Quiret JC, Quichaud J: Unlike heparin, low-molecular weight heparin does not suppress aldosterone production. Horm Metab Res 1989;21:402.

 goto top of outline Author Contacts

Anil Potti, MD
Department of Internal Medicine, University of North Dakota School of Medicine
1919 N Elm Street, Fargo, ND 58102 (USA)
Tel. +1 701 293 4131, Fax +1 701 293 4145, E-Mail

 goto top of outline Article Information

Received: Received: December 29, 2001
Accepted in revised form: February 16, 2002
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 9

 goto top of outline Publication Details

Pathophysiology of Haemostasis and Thrombosis
Official Journal of the ‘Mediterranean League against Thromboembolic Diseases’

Vol. 32, No. 3, Year 2002 (Cover Date: May-June 2002 (Released October 2002))

Journal Editor: H.C. Hemker, Maastricht
ISSN: 1424–8832 (print), 1424–8840 (Online)

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