Comparison of two low-molecular weight heparins (LMWHs) , tinzaparin and bemiparin, during hemodialysis
Christidou, F.N.; Frangia, T.K.; Bamichas, G.I.; Gionanlis, L.C.; Natse, T.A.; Georgoulis, I.E.; Sombolos, K.I.
International Journal of Clinical Pharmacology and Therapeutics 43(7): 335-338
2005
ISSN/ISBN: 0946-1965 PMID: 16035376 Document Number: 593272
The anticoagulant effects of two LMWHs, tinzaparin sodium and bemiparin sodium, were compared during two study dialysis (SD) sessions (SD1 with tinzaparin and SD2 with bemiparin) in ten chronic hemodialysis patients. Prior to SDI, patients had received 3,500 IU of tinzaparin in each dialysis session for two weeks. After SDI, they were switched to 3,500 IU of bemiparin for two weeks and the second study dialysis session (SD2) was carried out. Patients used the same dialyzers during the whole study period and no changes were made in any of the other hemodialysis parameters. Blood samples for the measurement of PT, aPTT and anti-Xa activity were taken before the study dialysis sessions (sample 0), and again at two and four hours after the initiation of dialysis (samples 2-h and 4-h, respectively). PT values showed no change between the SDI and SD2 sessions, but aPTT values were significantly higher in the 2-h and 4-h samples of the SDI session compared to corresponding values in SD2 samples (p < 0.005). Anti-Xa activity was higher in the 2-h and 4-h samples of the SD2 session compared to the SDI session (p = 0.005 and p = 0.012, respectively). At four hours, only patients receiving bemiparin had a mean anti-Xa activity higher than 0.40 IU/mg (mean 0.51 +/- 0.76). However, fibrin/clot formation in the extracorporeal circuit during each study period as assessed by visual inspection, did not differ significantly between sessions. It is concluded that the anticoagulant profile of bemiparin sodium during hemodialysis treatment is superior to that of tinzaparin.