engleski

Decreasing of nadroparine doses have influence on blood pressure in hemodialysed patients.

Objective: Patients receiving chronic haemodialysis (HD) have an increased risk of cardiovascular morbidity and mortality. Previous studies were described hypotensive effect of systemic heparin administration. The aim of this study was to assess the impact of decreasing single bolus doses of low molecular weight heparin (LMWH) nadroparine on blood pressure and pulse pressure (PP) among patients on HD. Design and Method: Forty patients (18 females) mean age 64, 93&#177; 12, 34 years undergoing intermittent HD for 62, 63&#177; 53, 97 months were included in this 12-weeks long prospective study. The recommended nadroparine bolus doses were decreased by 25% after 4 weeks, again by 25% after 8 weeks, and maintained 50% lower doses for 4 weeks. The blood pressure was measured at the beginning of each HD. The efficacy and safety of LMWH were assessed by dialysis system clotting and by noting bleeding, and the dose of LMWH was respectively changed. The differences between LMWH in the first and the last HD sessions were calculated (delta LMWH). Results: There were not differences between the first and the last predialysis systolic blood pressure (131, 05&#177; 25, 58 vs. 125, 92&#177; 25, 49 mmHg ; p=0, 133) nor predialysis diastolic blood pressure (73, 82&#177; 11, 82 vs. 72, 89&#177; 9, 13 mmHg ; p=0, 653) nor PP values (57, 24&#177; 20, 39 vs. 53, 03&#177; 21, 20 mmHg ; p=0, 121). There was difference between the first and the last LMWH dose (3800, 00&#177; 1361, 54 vs. 2475, 00&#177; 1159, 09 ; p<0, 001). There was correlation between delta LMWH and diastolic pressure on the beginning of the last HD session (r=0, 335 ; p=0, 021). Figure 1. There were not significant correlations between delta LMWH and systolic pressure nor PP values on the beginning of the last HD session (r=0, 075 ; p=0, 329 and r=-0, 052 ; p=0, 381). Conclusions: This is the first report of influence of nadroparine dose decreasing on blood pressure in HD patients. We demonstrated significant correlation between level of LMWH decreasing and rise in diastolic pressure.

nadroparine; hemodialysis; blood pressure

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