engleski

Influence of nadroparin decreasing on blood pressure in haemodialysed patients

INTRODUCTION: Patients receiving chronic haemodialysis (HD), especially diabetics, have an increased risk of arterial hypertension and cardiovascular morbidity. Previous studies were described hypotensive effect of systemic heparin administration. The aim of this study was to assess the impact of decreasing single bolus dose of low molecular weight heparin (LMWH) nadroparin on blood pressure among patients on HD. DESIGN AND METHOD: Forty patients (18 females), 20 diabetics, mean age 64, 93±12, 34 years (range 36-84) undergoing intermittent HD for 62, 63±53, 97 months (range 5-196) were included in this 12-weeks long prospective study. The recommended nadroparin bolus dose was 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 the dose of LMWH was respectively changed. RESULTS: Overall, there was difference between the first and the last LMWH dose but not between the first and the last predialysis blood pressure parameters (Table 1.). In the subgroup of diabetics the differences in the first and the last predialysis systolic and PP were found (Table 2.). CONCLUSION: This trial demonstrated the influence of lowering nadroparin doses on blood pressure in HD patients. The significant decreasing of LMWH level led to paradoxally decreasing in systolic and pulse pressure only in diabetics on chronic haemodialysis.

Hemodialysis; nadroparin; blood pressure

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