Heparin-induced thrombocytopenia among incident hemodialysis patients anticoagulated with low molecular weight heparin: A single-center retrospective study
Heparin-induced thrombocytopenia among incident hemodialysis patients anticoagulated with low molecular weight heparin: A single-center retrospective study
复制标题
低分子肝素抗凝的血液透析患者肝素诱导的血小板减少：一项单中心回顾性研究
DOI：
10.1016/j.nefro.2020.05.012
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Sugawara Akira
中科院分区：
文献类型：
--
作者：
Doi Yohei;Koga Kenichi;Sugioka Sayaka;Inoue Yui;Arisato Tetsuya;Nishioka Keisuke;Ishihara Takeshi;Sugawara Akira
肝素是血液透析治疗期间最常用的抗凝剂，用于维持滤器和体外循环管路通畅。肝素诱导的血小板减少症（HIT）可导致血栓栓塞，是肝素治疗的潜在严重并发症。尽管HIT的发生率因肝素类型和患者人群而异，但没有研究评价使用低分子量肝素（LMWH）抗凝的血液透析患者中HIT的发生率。在这项单中心、回顾性、观察性研究中，我们入组了2013年1月至2016年12月的连续事件血液透析患者。LMWH（帕那帕林钠）是血液透析的主要抗凝剂，所有临时或长期血液透析都是在我院的住院环境中开始的。事件性血液透析患者定义为在住院期间开始血液透析并在出院后接受定期血液透析的患者。我们排除了以下情况：（1）临时血液透析;（2）普通肝素（UFH）给药;（3）在重症监护室开始血液透析。为了识别HIT患者，我们回顾了所有进行HIT抗原免疫测定和/或血小板下降的患者
Heparin is the most commonly used anticoagulant to maintain filter and extracorporeal circuit patency during hemodialysis therapy. Heparin-induced thrombocytopenia (HIT), which results in thromboembolism, is a potentially critical complication of heparin therapy. Although the incidence of HIT varies depending on the type of heparin and patient population, no studies evaluated the incidence of HIT among incident hemodialysis patients anticoagulated with low molecular weight heparin (LMWH). In this single-center, retrospective, observational study, we enrolled consecutive incident hemodialysis patients from January 2013 to December 2016. LMWH (Parnaparin Sodium) was the primary anticoagulant for hemodialysis and all temporary or chronic hemodialysis was started in the inpatient setting at our institute. Incident hemodialysis patients were defined as those who had started hemodialysis during hospitalization and who received regular hemodialysis after discharge. We excluded the following:(1) temporary hemodialysis;(2) administration of unfractionated heparin (UFH); and (3) initiating hemodialysis in the intensive care unit. To identify patients with HIT, we reviewed all patients who conducted an antigen immunoassay for HIT and/or dropped platelet