Abstract
Adverse effects of heparin including lipolytic action, platelet activation, inhibition of aldosterone production, allergic reaction and osteolytic action have been reported. Recently, we experienced three patients with chronic renal failure on hemodialysis who manifested blood coagulation in the hemodialyzer and thrombocytopenia during heparinizing dialysis. We diagnosed them as having heparin-induced thrombocytopenia and treated them with lowmolecular-weight (LMW) heparin on dialysis. We also investigated platelet function in two of them. When LMW heparin was used, hyperactivation of β-TG and PF4 associated with thrombocytopenia were not observed during hemodialysis, in contrast with the use of normal unfractionated (UF) heparin. Furthermore, we found by in vitro study that enhanced platelet aggregation was induced by the addition of UF heparin to a mixture of normal plateletrich plasma, while by the addition of LMW heparin-induced platelet aggregation was not found.
Therefore, we conculuded that LMW heparin was useful for the treatment of hemodialyzed patients with heparin induced immune thrombocytopenia.
