Pathophysiology of Haemostasis and Thrombosis
Original Paper
Long-Term Use of the Low Molecular Weight Heparin Tinzaparin in HaemodialysisSimpson H.K.L.a · Baird J.a · Allison M.a · Briggs J.D.b · Rowe P.A.b · Welsh M.b · Macdougall A.I.c · Grant A.C.c · Lowe G.D.O.d · Rumley A.d · Wallace M.d · Menday A.P.eaRenal Unit, Glasgow Royal Infirmary, bRegular Dialysis Unit, Western Infirmary, cRenal Unit, Stobhill General Hospital, dUniversity Department of Medicine, Glasgow Royal Infirmary, Glasgow, and eLeo Laboratories, Princes Risborough, Bucks, UK
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Article / Publication Details
Received: February 06, 1995
Accepted: July 07, 1995
Published online: April 28, 2009
Issue release date: 1996
Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0
ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)
For additional information: https://www.karger.com/PHT
Abstract
Fifty-two patients with chronic renal failure undergoing hospital haemodialysis were given a single bolus dose of tinzaparin (Innohep, Leo Laboratories, UK) into the arterial side of the dialyser, for up to 43 consecutive dialyses. The mean tinzaparin dose at the beginning was 2,139 IU anti-Xa and at the end 2,186 IU anti-Xa. Overall, tinzaparin proved a satisfactory anticoagulant for 1,370 (96.0%) out of 1,427 dialyses. Significant clot formation was prevented in 1,326 (92.8%) out of 1,429 dialyses. The clinically effective dose was associated with a mean plasma anti-Xa activity 1 h after dosing of 0.4 IU/ ml and suppressed fibrinopeptide A formation for up to 4 h. Bleeding, from the skin or mucous membranes, was recorded at 27 (1.9%) of 1,408 dialyses. Prolonged fistula bleeding on completion of dialysis was recorded on only 20 occasions. Other haemorrhagic events included haematemesis, bruising and subconjunctival haemorrhage (each in 1 patient) and epis-taxis (2 patients). Three patients died during the study of causes considered unrelated to tinzaparin therapy, myocardial infarction (2 patients) and multiple myeloma. Other adverse events reported included vomiting (3 patients) and hypotension (3 patients). Three patients ceased treatment due to haematemesis, prolonged bleeding from fistula puncture and thrombosis of the arteriovenous access, respectively. A small, but statistically significant, increase within the normal reference range was recorded in the mean values for aspartate aminotransferase and alanine aminotransferase.
© 1996 S. Karger AG, Basel
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Article / Publication Details
Received: February 06, 1995
Accepted: July 07, 1995
Published online: April 28, 2009
Issue release date: 1996
Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0
ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)
For additional information: https://www.karger.com/PHT
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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