Abstract:

Objective To investigate the effect of low molecular weight heparin on blood lipids and dilatation function of endothelial function in maintenance hemodialysis patients. Methods We recruited 38 pre-dialysis and uremic patients, and assigned them into two groups: unfractionated heparin group (UFH, n=18) and low molecular weight heparin (Fragmin) group (LMWH, n=20). Individualized dose of UFH or Fragmin was injected to the arterial route before dialysis. At the time before dialysis and after dialysis for 6 and 12 months, plasma lipids and lipoproteins were measured, and high-resolution ultrasound examination was performed to measure the baseline diameter and the endothelium-dependent flow-mediate dilation (FMD) of brachial artery. We also included 20 adults with normal serum lipids as the controls. Results Significant increase in serum triglycerides (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed in both groups before hemodialysis. In LMWH group after the dialysis for 12 months, serum TG was decreased, and serum high density lipoprotein cholesterol (HDL-C) and LDL-C remained unchanged as compared with those before dialysis. In UFH group, however, serum TG and LDL-C were elevated, and serum HDL-C was decreased. In the 2 groups, baseline diameter of brachial artery became larger, and the FMD of brachial artery was impaired. After the dialysis for 12 months, the FMD was much lower in UFH group than in LMWH group. Conclusion The long-term use of LMWH instead of conventional heparin during dialysis is beneficial to improve the abnormal serum lipid profiles, to stabilize vascular endothelial function, and to prevent the endothelial function from further injury in hemodialysis patients.

Key words: Low molecular weight heparin, Lipids, Endothelium, Vasodilatafion