Alternative methods of anticoagulation for dialysis-dependent patients with heparin-induced thrombocytopenia.

Journal Article (Journal Article;Review)

Dialysis patients who are continually exposed to heparin are at risk for heparin-induced thrombocytopenia (HIT). Heparin-induced antibodies have been reported to occur in 0-12% of hemodialysis (HD) patients. The diagnosis or suspicion of HIT in this patient population requires careful confirmation of the diagnosis and substitution of heparin with an alternate anticoagulant for dialysis. Alternate agents such as the direct thrombin inhibitors (hirudin and argatroban) are available, but careful dosing and monitoring of the anticoagulant effect are required. Despite careful dosing, hemorrhagic complications have occurred with these agents. Unfortunately there are limited options for treatment of hemorrhagic complications and no specific antidotes are available for the direct thrombin inhibitors. In this report the currently available alternatives to heparin for dialysis, including dosing and monitoring recommendations, are reviewed.

Full Text

Duke Authors

Cited Authors

  • O'Shea, SI; Ortel, TL; Kovalik, EC

Published Date

  • January 2003

Published In

Volume / Issue

  • 16 / 1

Start / End Page

  • 61 - 67

PubMed ID

  • 12535303

International Standard Serial Number (ISSN)

  • 0894-0959

Digital Object Identifier (DOI)

  • 10.1046/j.1525-139x.2003.03014.x


  • eng

Conference Location

  • United States