Abstract: 【Abstract】 Objective To understand the effect of heparin saline for catheter locking after heparin-free dialysis on patients with bleeding risk by comparison of coagulation parameters before and after heparin-free dialysis and after heparin saline filling in catheter for 30 minutes with the baseline data in non-dialysis days.  Method A total of 26 patients were treated with heparin-free dialysis in our department from June to September, 2011. Their catheters were fully filled with 1:1 heparin saline (3,125U/ml) according to the volume marked on them. The coagulation parameters in non-dialysis days were recorded as the baseline data, and blood samples were taken at the time points of 5 minutes after starting dialysis, after dialysis but before catheter locking, and 30 minutes after catheter-locking. Results Activated partial thromboplastin time (APTT) at the 4 time points mentioned above were 28.75 (26.60-31.63), 32.65 (28.30-54.03), 28.25 (26.53-32.03), and 47.90 (35.80-199.65) seconds, respectively. There were no differences between the data after dialysis but before catheter locking and at baseline condition. However, the values after starting dialysis for 5 minutes and after filling the catheter with heparin saline for 30 minutes were longer than the baseline value (P=0.0003 and 0.0001, respectively), and their median values were also longer than the baseline value by 13.6% and 66.7%, respectively. After filling the catheters with heparin saline, other parameters including prothrombin time (PT) and international normalized ratio (INR) were longer than the values before heparin saline filling the catheters (P≤0.0001). Conclusion The effect of routine heparin-free dialysis on coagulation parameters is trivial. However, 1:1 heparin saline for locking the catheters leads to a significant increase of APTT beginning from starting dialysis to a certain period of time after dialysis. Therefore, heparin saline used for locking catheters may increase bleeding potentials in patients with higher bleeding risk.

Key words: Heparin/therapeutic use, Kidney dialysis, Catheter