Abstract:
:Background. Low molecular weight heparin (LMWH) is an effective anti-coagulant for thrombotic events. However, due to its predominant renal clearance, there are concerns that it might be associated with increased bleeding in patients with renal disease. Objectives. We systematically evaluated the efficacy and safety of LMWH compared to unfractionated heparin (UH) in end stage renal disease (ESRD) patients. Search Methods. Pubmed, Embase and cochrane central were searched for eligible citations. Selection Criteria. Randomized controlled trials, comparing LMWH and UH, involving adult (age > 18 years), ESRD patients receiving outpatient, chronic, intermittent hemodialysis were included. Data Collection and Analysis. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Random effects model was used for meta-analysis. Results. Nineteen studies were included for systematic review and 4 were included for meta-analysis. There were no significant differences between LMWH and UFH for extracorporeal circuit thrombosis [risk ratio: 1 (95% CI [0.62-1.62])] and bleeding complications [risk ratio: 1.16 (95% CI [0.62-2.15])]. Conclusions. LMWH is as safe and effective as UFH. Considering the poor quality of studies included for the review, larger well conducted RCTs are required before conclusions can be drawn.
journal_name
PeerJjournal_title
PeerJauthors
Palamaner Subash Shantha G,Kumar AA,Sethi M,Khanna RC,Pancholy SBdoi
10.7717/peerj.835subject
Has Abstractpub_date
2015-03-10 00:00:00pages
e835issn
2167-8359pii
835journal_volume
3pub_type
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