LOW DOSE GABEXATE MESILATE (GM) DIALYSIS UTILIZING SYNERGISM BETWEEN GM AND HEPARIN

Abstract

Gabexate mesilate (GM) and heparin showed synergism as anticoagulants in vitro. This synergism was observed between 20 to 50μg/ml of GM and 0.05μ/ml of heparin in the blood of hemodialysis (HD) patients. According to the result of in vitro experiment, 425 low dose GM dialyses were performed in 105 patients using 150μ of heparin at the priming of dialysis circuits and 500-600mg/H of GM during HD. There were neither clotting troubles during HD nor enhancement of bleeding tendencies during and after HD. Platelet adhesion to glass beads were more suppressed in dialyses using heparin for priming compared with dialyses using GM for priming. The synergism in vitro and in vivo between heparin and GM was interpreted as the result of the suppression of clotting system and platelet function. Probably this synergism were amplified in HD patients because their platelet count is decreased and their platelet function is deteriorated.