Abstract
Non anticoagulant hemodialysis (NAHD) is now possible in some patients with the recent advances in dialyzer technology. This study was designed to determine the important factors which may affect outcome in NAHD. Cuprophane and EVAL dialyzers (high shear rate types) were used in this study. Total doses on heparin, blood clotting time during a in after dialysis and the degree of clotting in dialyzers were analyzed prospectively in 53 patients, who underwent dialysis using either low dose heparinization or NAHD. Low dose heparin dialysis (LDHD) required 1742 units of heparin on the average during the treatment for 5 hours. There was no prolongation in blood clotting time after dialysis, although 50 to 85% of dialyzer fibers were clotted in 22.7% of 352 LDHD in 43 patients. Moderate to complete clotting of dialyzers was observed in 15% of 60 NAHD in 10 patients, who did not show any change in clotting time during and after treatment. No significant difference was seen in blood clotting time and the degree of clotting in dialyzers (cuphrophane and EVAL dialyzers). Judging from our experiences, we conclude that it is necessary for NAHD to use dialyzers with high shear rate and employ a specially designed blood tubing to obtain sufficient blood flow through dialyzer.
