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KMID : 0350519940470010653
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Journal of Catholic Medical College
1994 Volume.47 No. 1 p.653 ~ p.663
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Comparison of the Dialysis Effectiveness Between Systemic Heparinization and Hearin Free Hemodialysis
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Abstract
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This study was designed and undertaken to compare the dialysance and degree of dialyzer clotting between systemic heparinization and heaprin free hemodialysis in hemodialysis patients. The 34 patients who had received hemodialysis in Kangnam St.
Mary's
Hospital from March to June in 1993 were included. The patients were divided into two groups depending upon the presence of bleeding tendency: non-risk group(A, n=10) and risk group(B, n=24). In non-risk group, systemic heparinization(A1) was
compared
with heparin free dialysis(A2) in terms of dialysance and degree of dialyzer clotting. In risk group, the dialysance and degree of dialyzer clotting were evaluated according to the different method of 0.15 M NaC1 flush: 100 ml every 30 min(B1)
and
200ml
every hour(B2). The risk factors affecting the dialysance and degree of dialyzer clotting in the risk group were also evaluated.
@ES The results were as follows:
@EN 1. In non-risk group, there were no significant differences in dialysance, fluid removal or degree of dialyzer clotting between group A1 nd A2. WBC and platelet counts did not differ between group A1 and A2. aPTT levels remained normal during
dialysis in group A2, but significantly prolonged 15 min after starting of dialysis in group A1(p=0.043).
2. In risk group, dialysance, fluid removal or degree of dialyzer clotting did not differ between group B1 and B2.
3. Dialysance was correlated with hematocrit(r=0.44, p=0.031; r=0.64, p=0.0001 respectively) and degree of dialyzer clotting(p=0.0002) in both group B1and B2, and with arterial flow rate in group B2(r=0.48, p=0.015).
Degree of dialyzer clotting was correlated with transfusion during dialysis in both group B1(p=0.049) and B2 (p=0.013), and with hematocrit in group B2 (p=0.002).
4. Stepwise multiple regression employing hematocrit could develop predictor of dialysance in group B1(R*=0.0379), and degree of dialyzer clot, arterial flow rate and hematocrit could develop predictor of dialysance in group B2(R*=0.4277).
However,
arterial flow rate, blood pressure, venous pressure, hematocrit, dialysis time, type of vascular access and transfusion could not develop predictors of degree of dialyzer clotting.
In conclusion, heparin free dialysis should be considered as a simple, safe and effective method of hemodialysis in patients with high risk of bleeding tendency.
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KEYWORD
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