Comparative Study between Low Molecular Weight Heparin and Unfractionated Heparin on Lipids in Hemodialysis Patients

摘要

Objective: To evaluate effects of unfractionated heparin (UFH) and low molecular weight heparin (LMWH) on the level of triglycerides, cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) on hemodialysis patients. Background: End stage renal disease (ESRD) patients have a high risk of mortality, with cardiovascular diseases (CVD) being the commonest cause of death. Dyslipidemia is a major cause of CVD. A number of studies had evaluated the effect of both UFH and LMWH on lipid metabolism in ESRD patients. Methods: This study subjecting fifty patients with ESRD onmaintenance hemodialysis (HD) and last for six months. Twenty five patients using LMWH (enoxaparin) (9male and 16female) with mean age of 54.280 ± 6.668years and twenty five patients using UFH (13 male and 12 female) with mean age 56.920 ± 9.050 years. Serum cholesterol, triglycerides, HDL and LDL were determined. Demographic data and laboratory values were evaluated. Results: Our results show no significant difference between both groups regarding triglycerides level after the study (P=0.741) with more numerical decrease in triglycerides level in LMWH group (P=0.244). A significant increase in cholesterol level were found in UFH group after the study (P=0.009). Also the results show a significant increase in bleeding events in UFH group (P=0.020) and significant increase in coagulation problems in LMWH group (P=0.024). Conclusions: The results of this study indicate a more decrease in triglycerides level in patients using LMWH than UFH with significant increase in cholesterol level in UFH group. There were a significant increase in bleeding events in UFH patients and an increase in coagulation events in patients using LMWH. So we suggest using LMWH in patients with high serum cholesterol, triglyceridesand history of bleeding disorders and using UFH in patients with coagulation disorders.