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Thrombogenesis and Anticoagulation in Patients Undergoing Chronic Hemodialysis

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Replacement of Renal Function by Dialysis

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Abstract

A tendency toward thrombosis (particularly of the arterovenous shunt) is a frequent complication of uremic patients on hemodialysis. It is well known that uremia is associated with complex coagulation abnormalities (1–4) which include both bleeding diathesis (for a review see chapter by Winchester JF) and hypercoagulability. Table 1 shows the factors involved in the latter disturbance. The results of the global coagulation screening tests in uremic patients are generally normal. Most consistent findings are an increased level of fibrinogen (5) and decreased protein C anticoagulant activity with normal amidolytic activity and antigen (6, 7). Recently, it has been documented that the reduced protein C anticoagulant activity is due to the presence of a soluble plasma inhibitor that interferes specifically with the anticoagulant activity of activated protein C (8). Given the role of fibrinogen and protein C in coagulation homeostasis, it is not surprising that these abnormalities contribute to the increased risk of thrombosis episodes in these patients. In vivo studies have also demonstrated enhanced platelet activity in this population (9–11).

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References

  1. Remuzzi G: Bleeding in renal failure. Lancet 1: 1205, 1988

    PubMed  CAS  Google Scholar 

  2. Llach F: Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome. Kidney Int 28: 429, 1985

    PubMed  CAS  Google Scholar 

  3. Hocking WG: Hematologic abnormalities in patients with renal disease. Hematol Oncol ClinNorth Am 1: 229, 1987

    CAS  Google Scholar 

  4. Viganò G, Remuzzi G: Disorders of hemostasis in dialysis patients, in The Principles and Practice of Dialysis, edited by Henrich WL, Baltimore, Williams & Wilkins, 1994, p 287

    Google Scholar 

  5. Koppensteiner R, Stockenhuber F, Derfler K et al.: Fibrinogen in kidney disease, in Fibrinogen: A New Cardiovascular Risk Factor, edited by Ernest E, Koening W, Lowe GDO, Meade TW, Wien, Blackwell-MZV, 1992, p 301

    Google Scholar 

  6. Sorensen PJ, Knudsen F, Nielsen AH et al.: Protein C assay in uremia. Thromb Res 301, 1989

    Google Scholar 

  7. Sorensen PJ, Nielsen AH, Knudsen E, Dyerberg J: Defective protein C in uremia. Blood Purif 5: 29, 1987

    Article  PubMed  CAS  Google Scholar 

  8. Faioni EM, Franchi F, Krachmalnicoff A et al.: Lowlevels of the anticoagulant activity of Protein C in patients with chronic renal insufficiency: an inhibitor of Protein C is present in uremic plasma. Thromb Haemostas 66: 420, 1991

    CAS  Google Scholar 

  9. Viener A, Aviram M, Better OS, Brook JG: Enhanced in vitro platelet aggregation in hemodialysis patients. Nephron 43: 139, 1986

    PubMed  CAS  Google Scholar 

  10. Lindsay RM, Prentice CRM, Davidson JF et al.: Haemostatic changes during dialysis associated with thrombus formation on dialysis membranes. Br Med J 4: 454, 1972

    PubMed  CAS  Google Scholar 

  11. George CPR, Slichter SJ, Quadracci LJ et al.: A kinetic evaluation of hemostasis in renal disease. N Engl J Med 293: 1111, 1974

    Article  Google Scholar 

  12. Smith MC, Dunn MJ: Impaired platelet thromboxane production in renal failure. Nephron 29: 133, 1981

    Article  PubMed  CAS  Google Scholar 

  13. Jorgenson KA, Ingeborg S: Platelets and platelet function in patients with chronic uremia on maintenance hemodialysis. Nephron 23: 233, 1979

    Google Scholar 

  14. Nenci GG, Berrettini M, Agnelli G et al.: Effects of peritonela dialysis, hemodialysis and kidney transplantation on blood platelet function. Nephron 23: 287, 1979

    Article  PubMed  CAS  Google Scholar 

  15. Lindsay RM, Moorthy AV, Koens F, Linton AL: Platelet function in dialyzed and non-dialyzed patients with chronic renal failure. Clin Nephrol 4: 52, 1975

    PubMed  CAS  Google Scholar 

  16. Bemis J, Rigney J, Sosin A, Deane N: Enhanced platelet aggregation in chronic renal failure patients receiveing hemodialysis treatment. Trans Am Soc Artif Intern Organs 23: 48, 1977

    PubMed  CAS  Google Scholar 

  17. Garcia-Martin F, De Arriba G, Carrascosa T et al.: Anti-cardiolipin antibodies and lupus anticoagulant in end-stage renal disease. Nephrol Dial Transplant 6: 543, 1991

    PubMed  CAS  Google Scholar 

  18. Quereda C, Pardo A, Lamas S et al.: Lupus-like in vitro anticoagulant activity in end-stage renal disease. Nephron 49: 39, 1988

    PubMed  CAS  Google Scholar 

  19. Freyssinet JM, Ravanat C, Grunebaum L et al.: Anti-phospholipid autoantibodies in thrombosis: cause and/or consequence of the disruption of the protein C-dependent hemostatic balance, in Phospholipid-binding Antibodies, edited by Harris EN, Exner T, Hughes GRV, Asherson TA, Boca Raton, CRC Press, 1991, p 255

    Google Scholar 

  20. Forbes CD, Prentice CRM: Thrombus formation and artificial surfaces. Br Med Bull 34: 201, 1978

    PubMed  CAS  Google Scholar 

  21. Lindsay RM, Mason RG, Kim SW, Andrade JD, Hakim RM: Blood surface interactions — report of ASAIO panel conference. Trans Am Soc Artif Intern Organs 26: 603, 1980

    PubMed  CAS  Google Scholar 

  22. Fan P, Schwab SJ: Hemodialysis vascular access, in The Principles and Practice of Dialysis, edited by Henrich WL, Williams & Wilkins, Baltimore, 1994, p 22

    Google Scholar 

  23. Galbraith S, Fan P, Collins D, Schawb S: Hemodialysis fistula thrombosis: a prospective evaluation of anatomic vs nonanatomic causes. J Am Soc Nephrol 3: 365, 1992

    Google Scholar 

  24. Feldman HI, Held PJ, Stoiber E et al.: Dialysis vascular access morbidity in the USA. J Am Soc Nephrol 1: 356, 1991

    Google Scholar 

  25. Del Greco F, Soper WS, Krumlovsky FA et al.: Thrombosis of vascular access for hemodialysis. in Haemostasis and the Kidney, edited by Remuzzi G, Rossi EC, Butterworths, London, 1989, p 303

    Google Scholar 

  26. Kirschbaum B, Mullinax F, Curry N, Mallory J: Association between anticardiolipin antibody and frequent clotting problems in hemodialysis patients. J Am Soc Nephrol 2: 232, 1991

    Google Scholar 

  27. Alegre A, Vicente V, Gonzales R, Alberca I: Effect of hemodialysis on Protein C. Nephron 46: 386, 1987

    PubMed  CAS  Google Scholar 

  28. Lai KN, Yin JA, Yuen PMP, Li PKT: Effect of hemodialysis on protein C, protein S, and antithrombin III levels. Am J Kidney Dis 17: 38, 1991

    PubMed  CAS  Google Scholar 

  29. Palder SB, Kirkman RL, Wittermore AD, Hakim RM, Lazarus JM, Tilney NL: Vascular access for hemodialysis. Ann Surg 202: 235, 1985

    PubMed  CAS  Google Scholar 

  30. Zibari GB, Rohr MS, Landreneau MD et al.: Complications from permanent hemodialysis vascular access. Surgery 104:681, 1988

    PubMed  CAS  Google Scholar 

  31. Raju S: PTFE grafts for hemodialysis access. Ann Surg 206: 666, 1987

    Article  PubMed  CAS  Google Scholar 

  32. Winearls CG, Pippard MJ, Dowing MR et al.: Effect of human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic haemodialysis. Lancet 2: 1175, 1986

    PubMed  CAS  Google Scholar 

  33. Ad Hoc Committee for the National Kidney Foundation: Statement on the clinical use of recombinant erythropoietin in anemia of end-stage renal disease. Am J Kidney Dis 14: 163, 1989

    Google Scholar 

  34. Viganò G, Benigni A, Mendogni D, Mingardi G, Mecca G, Remuzzi G: Recombinant human erythropoietin to correct uremic bleeding. Am J Kidney Dis 18: 44, 1991

    PubMed  Google Scholar 

  35. Eschbach JW: Erythropoietin 1991 — an overview. Am J Kidney Dis 18(Suppl I): 3, 1991

    PubMed  CAS  Google Scholar 

  36. Eschbach JW, Adamson JW: Guidelines for recombinant human erythropoietin therapy. Am J Kidney Dis 14(Suppl 1): 2, 1989

    PubMed  CAS  Google Scholar 

  37. Eschbach JW, Adamson JW: Recombinant human erythropoietin: implication for nephrology. Am J Kidney Dis 11:203, 1988

    PubMed  CAS  Google Scholar 

  38. Taylor JE, Belch JJ, McLaren M, Henderson IS, Stewart WK: Effect of erythropoietin therapy and withdrawal on blood coagulation and fibrynolysis in hemodialysis patients. Kidney Int 44: 182, 1993

    PubMed  CAS  Google Scholar 

  39. MacDougall IC, Davies ME, Hallett I, Cichlin DL, Hutton RD, Coles GA, Williams JD: Coagulation studies and fistula blood flow during erythropoietin therapy in haemodialysis patients. Nephrol Dial Transplant 6: 862, 1991

    PubMed  CAS  Google Scholar 

  40. Muirhead N, Laupacis A, Wong C: Erythropoietin for anaemia in haemodialysis patients: results of a maintenance study. Nephrol Dial Transplant 7: 811, 1992

    PubMed  CAS  Google Scholar 

  41. Shand BI, Buttimore AL, Hurrell MA et al.: Hemorheology and fistula function in home hemodialysis patients following erythropoietin treatment: a placebo-controlled study. Nephron 64: 53, 1993

    PubMed  CAS  Google Scholar 

  42. Standage BA, Schuman ES, Ackerman D, Gross GF, Rangsdale JW: Does the use of erythropoietin in hemodialysis patients increase dialysis graft thrombosis rates? Am J Surg 165: 650, 1993

    PubMed  CAS  Google Scholar 

  43. Zeit RM, Cope C: Failed hemodialysis shunts. Radiology 154: 353, 1985

    PubMed  CAS  Google Scholar 

  44. Young AT, Hunter DW, Castaneda-Zuniga WP et al.: Thrombosed synthetic hemodialysis access fistulas: failure of thrombolytic therapy. Radiology 154: 639, 1985

    PubMed  CAS  Google Scholar 

  45. Mangiarotti G, Canavese C, Thea A et al.: Urokinase treatment for arteriovenous fistulae declotting in dialyzed patients. Nephron 36: 60, 1984

    Article  PubMed  CAS  Google Scholar 

  46. Schilling JJ, Eiser AR, Slifkin RF, Withney JT, Neff MS: The role of thrombolysis in hemodialysis access occlusion. Am J Kidney Dis 10: 92, 1987

    PubMed  CAS  Google Scholar 

  47. Rodkin RS, Bookstein JJ, Heeney DJ, Davis GB: Strep-tokinase and transluminal angioplasty in the treatment of acutelythrombosed hemodialysis access fistulas. Radiology 149: 425, 1983

    PubMed  CAS  Google Scholar 

  48. Tordoir JHM, Herman JMMPH, Kwan TS, Diderich PM: Long-term follow-up of the polytetrafluoroethylene (PFTE) prosthesis as an arteriovenous fistula for haemodialysis. Eur J Vase Surg 2: 3, 1987

    Google Scholar 

  49. Brunner MC, Matalon TA, Patel SK, McDonald V, Jensik SC: Ultrarapid urokinase in hemodialysis access occlusion. J Vasc Intervent Radiol 2: 503, 1991

    CAS  Google Scholar 

  50. Valji K, Bookstein JJ, Roberts AC, Davis GB: Pharma-comechanical thrombolysis and angioplasty in the management of clotted hemodialysis grafts: early and late clinical results. Radiology 178: 243, 1991

    PubMed  CAS  Google Scholar 

  51. Matuszkiewicz-Rowinska J, Billip T, Omecka Z, Rowinski W, Sicinski A: Systemic streptokinase infusion for declotting of hemodialysis arteriovenous fistulas. Nephron 66: 67, 1994

    PubMed  CAS  Google Scholar 

  52. Ahmed A, Shapiro WB, Porush JG: The use of tissue plasminogen activator to declot arteriovenous accesses in hemodialysis patients. Am J Kidney Dis 21: 38, 1993

    PubMed  CAS  Google Scholar 

  53. Sreedhara R, Himmelfarb J, Lazarus JM, Hakim RM: Antiplatelet therapy in expanded polytetrafluoroethylene (ePTFE) graft thrombosis: results of a randomized double-blind study. J Am Soc Nephrol 4: 388 (Abstract 9P), 1993

    Google Scholar 

  54. Michie DD, Wombolt DG: Use of sulfilnpyrazone to prevent thrombus formation in arteriovenous fistulas and bovine grafts of patients on chronic hemodialysis. Ther Res 22: 196, 1977

    Google Scholar 

  55. Kobayashi K, Maeda K, Koshikawa S et al.: Antithrombotic therapy with ticlopidine in chronic renal failure patients on maintenance hemodialysis — a multicenter collaborative double blind study. Thromb Res 20: 255, 1980

    PubMed  CAS  Google Scholar 

  56. Domoto DT, Bauman JE, Joist JH: Combined aspirin sulfynpirazone in the prevention of recurrent hemodialysis vascular access thrombosis. Thromb Res 82: 737, 1991

    Google Scholar 

  57. Harter HR, Burch JW, Majerus PW et al.: Prevention of thrombosis in patients on hemodialysis by low dose aspirin. N Engl J Med 301: 577, 1979

    Article  PubMed  CAS  Google Scholar 

  58. Livio M, Benigni A, Viganò G, Mecca G, Remuzzi G: Moderate doses of aspirin and risk of bleeding in renal failure. Lancet 1: 414, 1986

    PubMed  CAS  Google Scholar 

  59. Gaspari F, Viganò G, Orisio S, Bonati M, Livio M, Remuzzi G: Aspirin prolongs bleeding time in uremia by a mechanism distinct from platelet cyclooxygenase inhibition. J Clin invest 79: 1788, 1987

    PubMed  CAS  Google Scholar 

  60. Steiner RW, Coggins C, Carvalho ACA: Bleeding time in uremia. Am J Hematol 7: 107, 1979

    PubMed  CAS  Google Scholar 

  61. Viganò G, Remuzzi G: Low-dose aspirin and bleeding in uremia. Am J Hematol 42: 235, 1993

    PubMed  Google Scholar 

  62. Antiplatelet Trialists’ Collaboration: Collaborative overview of randomized trials of antipylatelet therapy. II: Maintenance of vascular graft of arterial patency by antiplatelet therapy. Br Med J 308: 159, 1994

    Google Scholar 

  63. Sreedhara R, Himmelfarb J, Lazarus JM, Hakim RM: Antiplatelet therapy in graft thrombosis: results of a prospective, randomized double-blind study. Kidney Int 45: 1477, 1994

    PubMed  CAS  Google Scholar 

  64. Tollefaen DM, Majerus DW, Blank MK: Heparin cofactor II. J Biol Chem 257: 2162, 1982

    Google Scholar 

  65. Salzman EW, Rosenberg RD, Smith MH, Lindon JN, Favreau L: Effect of heparin and fractions on platelet aggregation. J Clin Invest 65: 64, 1980

    PubMed  CAS  Google Scholar 

  66. Hirsh J, Ofosu F, Buchanan M: The rationale behind the development of low molecular weight heparin derivatives. Semin Thromb Haemostas 11, 13, 1985

    Article  CAS  Google Scholar 

  67. Koch KM, Bechstein PB, Fassbinder W, Kaltwasser P, Schoeppe W: Occult blood loss and iron balance in chronic renal failure. Proc Eur Dial Transplant Assoc 12: 681, 1975

    Google Scholar 

  68. Larsson SO: On coagulation and fibrinolysis in uraemic patients on maintenance hemodialysis. Acta Med Scand 189: 453, 1971

    Article  PubMed  CAS  Google Scholar 

  69. Wessel-Aas T, Blomhoff JP, Wirum E, Nilson T: Hemodialysis and cell toxicity in vitro related to plasma triglycerides, post-heparin lipolytic activity and free fatty acids. Acta Med Scand 216: 75, 1984

    Article  PubMed  CAS  Google Scholar 

  70. Schrader J, Stibbe W, Armstrong VW et al.: Comparison of low molecular weight heparin to standard heparin in hemodialysis/hemofiltration. Kidney Int 33: 890, 1988

    PubMed  CAS  Google Scholar 

  71. Adelman B, Sobel M, Fuhimura Y, Ruggero ZM, Zimmerman TS: Heparin-associated trombocytopenia: observations on the mechanism of platelet aggregation. J Lab Clin Med 113: 204, 1989

    PubMed  CAS  Google Scholar 

  72. Chong BH, Grace CS, Rozenberg MC: Heparin-induced trombocytopenia: effect of heparin platelet antibody on platelets. Br J Haematol 49: 531, 1981

    PubMed  CAS  Google Scholar 

  73. Chong BH, Pitney WR, Castaldi PA: Heparin-induced thrombocytopenia: association of thrombotic complications with heparin-dependent IgG antibody that induces thromboxane synthesis in platelet aggregation. Lancet 2: 1246, 1982

    PubMed  CAS  Google Scholar 

  74. Stead RB, Schafer AI, Rosenberg RD et al.: Heterogeneity of heparin lots associated with thrombocytopenia and thromboembolism. Am J Med 77: 185, 1984

    PubMed  CAS  Google Scholar 

  75. Matzsch T, Bergqvist D, Hedner U, Nilsson B, Ostergaard P: Heparin-induced osteoporosis in rats. Thromb Haemost 56: 293, 1986

    PubMed  CAS  Google Scholar 

  76. Ringe JD, Becker K: Osteoporoseentwicklung bei Heparinlangzeit Therapie. Med Mo Pharm 8: 80, 1955

    Google Scholar 

  77. Majdalani G, Chomat J, Kanchko A, Yanai M, Man NK: Kinetics of technetium-labeled heparin in hemodialyzed patients. Kidney Int 41(Suppl): 5131, 1993

    Google Scholar 

  78. Salzman EW: Low molecular weight heparin. Is small beautiful? N Engl J Med 315: 957, 1986

    Article  PubMed  CAS  Google Scholar 

  79. Thomas DR, Barrowwcliffe TW, Curtis AD. Low molecular weight heparin: a better drug? Haemostasis 16: 87, 1986

    PubMed  CAS  Google Scholar 

  80. Ireland H, Lane DA, Curtis JR: Objective assessment of heparin requirements for hemodialysis in humans. J Lab Clin Med 103: 643, 1984

    PubMed  CAS  Google Scholar 

  81. Schrader J, Stibbe W, Kandt M, Warneke G, Armstrong V, Muller HJ, Scxheler F: Low molecular weight heparin versus standard heparin. A long term study in hemodialysis and hemofiltration patients. Trans Am Soc Artif Intern Organs 36: 28, 1990

    CAS  Google Scholar 

  82. Nurmohamed MT, Ten Cate J, Stevens P, Hoeh JA, Lins RL, Ten Cate JW: Long term efficacy and safety of a low molecular weight heparin in chronic hemodialysis patients. A comparison with standard heparin. Trans Am Soc Artif Intern Organs 37: M459, 1991

    CAS  Google Scholar 

  83. Lindholm DD, Murray JS: A simplified method of regional heparinization during hemodialysis according to a pre-determined dosage formula. Trans Am Soc Artif Intern Organs 10: 92, 1964

    PubMed  CAS  Google Scholar 

  84. Spencer P, Cozzi E, Easterling RE, Penner JA: Regional heparinization with hollow fiber artificial kidney. Proc AANNT 4: 69, 1977

    Google Scholar 

  85. Gordon LA, Somon ER, Rukes JM, Richards V, Perkins HA: Studies in regional heparinization. N AE J Med 255: 1063, 1956

    Article  CAS  Google Scholar 

  86. Blaufox MD, Hampers CL, Merril JP: Heparinization for hemodialysis. Trans Am Soc Artif Intern Organs 12: 207, 1966

    PubMed  CAS  Google Scholar 

  87. Hampers CL, Blaufox MD, Merrill JP: Anticoagulation rebound after hemodialysis. N Engl J Med 275: 776, 1966

    Article  PubMed  CAS  Google Scholar 

  88. Pinnick E, Wiegmanson TE, Diederick DA: Regional citrate anticoagulation for hemodialysis in the patient at high risk for bleeding. N Engl J Med 308: 258, 1983

    Article  PubMed  CAS  Google Scholar 

  89. Lohr JW, Slusher S, Diederich D: Safety of regional citrate hemodialysis in acute renal failure. Am J Kidney Dis 13: 104, 1989

    PubMed  CAS  Google Scholar 

  90. Collart F, Tielemans C, Wens R, Drawta M: Local experience of regional anticoagulation with sodium citrate for hemodialysis in patients at risk of bleeding. Proc Eur Dial Transplant Assoc-Eur Renal Assoc 22: 325, 1985

    Google Scholar 

  91. Morita Y, Johnson RW, Dorn RE, Hall DS: Regional anticoagulation during hemodialysis using citrate. Am J Med Sci 242: 32, 1961

    PubMed  CAS  Google Scholar 

  92. Von Brecht JH, Flanigan MJ, Freeman RM et al.: Regional anticoagulation. Hemodialysis with hypertonic trisodium citrate. Am J Kidney Dis 8: 196, 1986

    Google Scholar 

  93. MacDougall M, Seaton R, Diederich D, Wiegmann T: Effects of both composition and dialyzer membrane on leukocytes and oxygenation during hemodialysis with citrate anticoagulation. Kidney Int 25: 188, 1984

    Google Scholar 

  94. Flanigan MJ, Von Brecht J, Freeman RM, Lim VS: Reducing the hemorrhagic complications of dialysis. A controlled comparison of low dose heparin and citrate anticoagulation. Am J Kidney Dis 9: 147, 1987

    PubMed  CAS  Google Scholar 

  95. Kelleher SP, Schulman G: Severe metabolic alkalosis complicating regional citrate hemodialysis. Am J Kidney Dis 9: 235, 1987

    PubMed  CAS  Google Scholar 

  96. Turney JH, Fewell MR, Williams LC, Parsons V, Weston MJ: Platelet protection and heparin sparing with prot-sacyclin during regular dialysis therapy. Lancet 2: 219, 1980

    PubMed  CAS  Google Scholar 

  97. Turney JH, Woods HF, Weston MJ: The use of prostacyclin in extracorporeal circuits. in Hemostasis, Prostaglandins and Renal Disease, edited by Remuzzi G, Mecca G, de Gaetano G, New York, Raven Press, 1980, p 353

    Google Scholar 

  98. Swartz RD, Flamenbaum W, Dubrow A, Hall JC, Crow JW, Cato A: Epoprostenol during high risk hemodialyis-preventing further bleeding complications. J Clin Pharmacol 28: 818, 1988

    PubMed  CAS  Google Scholar 

  99. Zussman RM, Rubin RH, Cato AE, Cocchetto DM, Crow JW, Tolkoff-Rubin N: Hemodialysis using prostacyclin instead of heparin as the sole antithrombotic agent. N Engl J Med 304: 934, 1981

    Article  Google Scholar 

  100. Hory B, Saint-Hiller Y, Perol JC: Prostacyclin as the sole anti-thrombotic agent for acute renal failure hemodialysis. Nephron 33: 71, 1983

    PubMed  CAS  Google Scholar 

  101. Davies SJ, Hobson SM, Young GA, Turney JH: Acute changes in plasma free fatty acid concentratioon during hemodialysis comparing heparin with epoprostenol as anticoagulant. Proc Eur Dial Transplant Assoc-Eur Renal Assoc 22: 321, 1985

    CAS  Google Scholar 

  102. Smith MC, Danviriyasup K, Crow JW, Cato AE, Park GD, Hassid A, Dunn MJ: Prostacyclin substitution for heparin in long-term hemodialysis. Am J Med 73: 669, 1982

    PubMed  CAS  Google Scholar 

  103. Dubrow A, Flamenbaum W, Mittman N, Hall J, Zinn T: Safety and efficacy of epoprostenol (PGI2) versus heparin in hemodialysis. Trans Am Soc Artif Intern Organs 30: 52, 1984

    PubMed  CAS  Google Scholar 

  104. Addonizio VP, Fisher CA, Bowen JC, Palatianos GC, Colman RW, Edmunds LH: Prostacyclin in lieu of anti-coagulation with heparin for extracorporeal circulation. Trans Am Soc Artif Intern Organs 27: 304, 1981

    PubMed  CAS  Google Scholar 

  105. Glaser P, Guesde R, Rouby JJ, Eurin B: Hemodialysis without heparin is possible. Lancet 2: 579, 1980

    Google Scholar 

  106. Sanders PW, Taylor H, Curtis JJ: Hemodialysis without anticoagulation. Am J Kidney Dis 5: 32, 1985

    PubMed  CAS  Google Scholar 

  107. Casati S, Moia, Graziani G et al.: Hemodialysis without anticoagulants: efficiency and hemostatic aspects. Clin Nephrol 21: 102, 1984

    PubMed  CAS  Google Scholar 

  108. Schwab SJ, Omorato JJ, Sharar LR, Dennis PA: Hemodialysis without anticoagulation. One year prospective trial in hospitalized patients at risk of bleeding. Am J Med 83: 405, 1987

    PubMed  CAS  Google Scholar 

  109. Raja RM, Kramer M, Rosenbaum JL et al.: Haemodialysis without heparin infusion using CORDIS DOW 3500 hollow filter. Proc Dial Transplant Forum 10: 39, 1980

    CAS  Google Scholar 

  110. Caruana RJ, Raja RM, Bush JV, Kramer MS, Goldsmith SJ: Heparin free dialysis: comparative data and results in high risk patients. Kidney Int 31: 1351, 1987

    PubMed  CAS  Google Scholar 

  111. Ryan KE, Lane DA, Flynn A et al.: antithrombotic properties of dermatan sulphate (MF 701) in haemodialyis for chronic renal failure. Thromb Haemost 68: 563, 1992

    PubMed  CAS  Google Scholar 

  112. Nurmohamed MT, Roggekamp M, Buller HR, Erkamp R, Stevens P, Ten Cate JW: A randomized cross-over study of dermatan sulphate and combination with heparin as anticoagulant in chronic haemodialysis patients. Thromb Haemost 65 (Abstract): 925, 1991

    Google Scholar 

  113. Fernandez F, Van Ryn J, Ofosu FA, Hirsh J, Buchanan MR: The haemorrhagic and antithrombotic effects of dermatan sulphate. Br J Haematol 64: 309, 1986

    PubMed  CAS  Google Scholar 

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  1. Clinical Res.Cntr. for Rare Diseases ‘Aldo e Cele Daccb’, Mario Negri Inst. for Pharmacol. Res., Villa Camozzi, 1-24020, Ranica, Italy

    Gianluigi Viganò M.D. & Arrigo Schieppati M.D.

  2. Division of Nephrology and Dialysis, Ospedali Riuniti di Bergamo, 1-24100, Bergamo, Italy

    Giuseppe Remuzzi M.D.

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  1. Gianluigi Viganò M.D.
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  2. Arrigo Schieppati M.D.
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  3. Giuseppe Remuzzi M.D.
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C. Jacobs C. M. Kjellstrand K. M. Koch J. F. Winchester

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Viganò, G., Schieppati, A., Remuzzi, G. (1996). Thrombogenesis and Anticoagulation in Patients Undergoing Chronic Hemodialysis. In: Jacobs, C., Kjellstrand, C.M., Koch, K.M., Winchester, J.F. (eds) Replacement of Renal Function by Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-36947-1_13

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