Hemodialysis - Anticoagulation (HD) without Bleeding Risk

Guideline Organization

Recommendation (Evidence Level)

Evidence

Comments

CARI-Australia
(2004)

No difference in dialysis adequacy between standard heparin and low molecular weight heparins (Level II)
No clear difference in the risk of thrombosis or hemorrhage (Level I)
LMWH are simpler and more convenient (Opinion)

Haemodialysis anticoagulation and adequacy

CSN - Canada

EBPG – Europe
(2002)

• Unfractionated and low molecular weight (LMWH) can be used. (Level A)
• Because of:
1. proven safety; (Level A)
2. equal efficacy; (Level A)
3. easy handling, (Level C)

The use of LMWH should
be preferred
• Other benefits are:
1. improved lipid profile; (Level B)
2. less hyperkalemia; (Level B)
3. less blood loss (Level C)

V.2 Prevention of clotting in the hemodialysis patient with normal bleeding risk
 

Guideline V.2.2

KDOQI - US

RA - UK