Thrombocytopenia in a home hemodialysis patient with NxStage system

摘要

Editor A 56-year-old man with progressive diabetic kidney disease who recently started conventional hemodialysis, was interested in home hemodialysis, started undergoing home hemodialysis training using NxStage System One, with heparin as an anticoagulant. After 3-4 weeks of training, blood work showed a significant drop in platelet count (from 172 to 107) that dropped further to 83. We wondered about converting the patient to conventional therapy, or using an alternate anticoagulant, or switching to peritoneal dialysis. However, though all these options were possible but had drawbacks-higher annual cost and not supporting patient choice with conventional hemodialysis, and the higher cost of an alternate anticoagulant if used [1].