Acute Effect of Heparin on Lipid Parameters in Patients on Renal Replacement Therapy

Katopodis, Konstantinos P.; Koliousi, Elli; Gouva, Chariklia; Balafa, Olga; Bairaktari, Eleni; Ikonomou, Margarita; Elisaf, Moses; Siamopoulos, Kostas C.

doi:10.1097/01.mat.0000247155.20214.20

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…This early phase of high LPL activity in the circulating blood is reflected by decreased levels of TG [5,19,20]. In agreement with Akiba et al [21] and Katopodis et al [19] we found that this early fall of plasma TG was less marked with the LMW-heparin than with the UF-heparin. There was a similar trend in the earlier study by Näsström et al [5] but in that case the difference did not reach statistical significance.…”

Section: Discussionsupporting

confidence: 90%

“…Only a fraction of the lipoprotein particles are "marginated" at the endothelium, in contact with LPL [18]. This early phase of high LPL activity in the circulating blood is reflected by decreased levels of TG [5,19,20]. In agreement with Akiba et al [21] and Katopodis et al [19] we found that this early fall of plasma TG was less marked with the LMW-heparin than with the UF-heparin.…”

Section: Discussionsupporting

confidence: 88%

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Lipoprotein lipase responds similarly to tinzaparin as to conventional heparin during hemodialysis

et al. 2010

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BackgroundLow molecular weight (LMW) heparins are used for anticoagulation during hemodialysis (HD). Studies in animals have shown that LMW-heparins release lipoprotein lipase (LPL) as efficiently as unfractionated (UF) heparin, but are less able to retard hepatic uptake of the lipase. This raises a concern that the LPL system may become exhausted by LMW-heparin in patients on HD. We have explored this in the setting of clinical HD.MethodsTwenty patients on chronic hemodialysis were switched from a primed infusion of UF-heparin to a single bolus of tinzaparin. There were long term follow up of variables for the estimation of dialysis efficacy as well as of the LPL release during dialysis and the subsequent impact on the triglycerides.ResultsThe LPL activity in blood was higher on tinzaparin at 40 but lower at 180 minutes during HD. These values did not change during the 6 month study period. There were significant correlations between the LPL activities in individual patients at the beginning and end of the 6 month study period and between the activities on UF-heparin and on tinzaparin, indicating that tissue LPL was not being exhausted. Triglycerides were higher during the HD-session with tinzaparin than UF-heparin. The plasma lipid/lipoprotein levels did not change during the 6 month study period, nor during a 2-year follow up after the switch from UF-heparin to tinzaparin. Urea reduction rate and Kt/V were reduced by 4 and 7% after 6 months with tinzaparin.ConclusionOur data demonstrate that repeated HD with UF-heparin or tinzaparin does not exhaust the LPL-system.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Lipoprotein lipase responds similarly to tinzaparin as to conventional heparin during hemodialysis

et al. 2010

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“…Another study by Katopodis et al [8] has shown that a reduction in TG levels in first, second and third hour administration of unfractionated IV heparin in patient on renal replacement therapy. Although the aforementioned studies determined the effect of administered heparin by on lipid TG, this study used in vitro heparin anticoagulant tube.…”

Section: Discussionmentioning

confidence: 94%

Influence of K2EDTA, sodium citrate and lithium heparin anticoagulants on lipid profile in plasma samples as measured by an automated chemical analyzer

Anto¹,

Owiredu²,

Obirikorang³

et al. 2017

Biomed Res Clin Prac

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“…Based on this information hemodialysis seems to have a powerful capacity for modifying the lipid pro ile, inducing hepatic secretion of LDL and increasing the amount of cholesterol mobilized by HDL. Therefore, hemoconcentration is not the only factor responsible for lipid pro ile changes [19].…”

Section: Discussionmentioning

confidence: 99%

Effect of hemodialysis session on acute changes in inflammatory and cardiovascular risk biomarkers

Gomez¹,

Unzueta²,

Ruiz³

et al. 2020

J Cardiol Cardiovasc Med

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How to cite this article: Gómez BAL, Unzueta MTG, Ruiz ARG, San-Martín SP, Berja A, et al. Effect of hemodialysis session on acute changes in infl ammatory and cardiovascular risk biomarkers. J Cardiol Cardiovasc Med. 2020; 5: 004-0010. AbstractBackground: Infl ammation is associated with enhanced cardiovascular risk profi le and increased cardiovascular mortality in end-stage kidney disease patients undergoing hemodialysis. Mechanisms of activated acute phase reaction in patients on chronic hemodialysis remain to be identifi ed. As successful treatment of the infl ammatory condition in these patients may improve long-term survival, we studied potential changes in different infl ammatory biomarkers of cardiovascular risk in end-stage kidney disease patients after a mid-week hemodialysis session.Methods: Infl ammatory biomarkers of cardiovascular risk (cystatin-C, homocysteine, C-reactive protein, procalcitonin, pentraxin-3, serum amyloid-A) and atherogenic plasma lipoproteins (Lipoprotein(a), cholesterol low and high density lipoproteins) were studied in 21 end-stage kidney disease patients previously and after a mid-week hemodialysis session. Results:We found a signifi cant reduction in serum levels of low molecular weight molecules: cystatin-C (5.56 to 1.85 mg/L, 66.73%, p < 0.001), homocysteine (22.85 to 13.25 μmol/L, 42.01%, p < 0.001) and procalcitonin (0.788 to 0.457 ng/mL, 42.01%, p < 0.001). Large molecules as C-reactive protein (9.70 to 9.90 mg/L, 2.06%, p = 0.022) and pentraxin-3 (1.67 to 4.28 ng/mL, 156%, p < 0.001) increased, but serum amyloid-A decreased (15.90 to 12.70 mg/L, 20.13%, p < 0.05). There was no change in Lipoprotein (a) levels. Conclusion:Pentraxin-3 was a more specifi c infl ammatory vascular marker than C-reactive protein, and the best infl ammatory marker associated with hemodialysis. Homocysteine, procalcitonin and the other small proteins could be released and removed during hemodialysis session. Further studies are needed to understand the behavior and signifi cance of these markers after successive hemodialysis.Effect of hemodialysis session on acute changes in infl ammatory and cardiovascular risk biomarkers https://www.heighpubs.org/jccm 005 https://doi.org/10.29328/journal.jccm.1001077Effect of hemodialysis session on acute changes in infl ammatory and cardiovascular risk biomarkers https://www.heighpubs.org/jccm 006 https://doi.

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Acute Effect of Heparin on Lipid Parameters in Patients on Renal Replacement Therapy

Cited by 8 publications

References 20 publications

Lipoprotein lipase responds similarly to tinzaparin as to conventional heparin during hemodialysis

Lipoprotein lipase responds similarly to tinzaparin as to conventional heparin during hemodialysis

Influence of K2EDTA, sodium citrate and lithium heparin anticoagulants on lipid profile in plasma samples as measured by an automated chemical analyzer

Effect of hemodialysis session on acute changes in inflammatory and cardiovascular risk biomarkers

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