Clotting by heparin of hemoaccess for hemodialysis in an end-stage renal disease patient
American Journal of Kidney Diseases
Arteriovenous graft; clotting; end-stage renal disease; hemodialysis; heparin; heparin-dependent platelet antibody
Clotting of vascular access in hemodialysis patients remains a significant problem. The routine use of heparin to anticoagulate the blood during hemodialysis has been helpful in increasing the life span of vascular access in these patients. However, the use of heparin is not without complications. Heparin-induced thrombocytopenia is one of the well-recognized drug-induced thrombocytopenic disorders that by itself usually does not cause serious morbidity. A small proportion of these patients concomitantly develop "paradoxic" acute thrombotic complications. Myocardial infarction, ischemic damage to lower extremities leading to amputation, and cerebrovascular accident with permanent neurologic deficits or leading to death are just some of the disastrous complications. We report a case of paradoxic clotting of the hemoaccess in a patient receiving hemodialysis treatment associated with the use of heparin that has not been previously described. The patient had heparin-dependent platelet antibody resulting in a decrease in platelet count and clotting of the hemoaccess. © 1995.
Pham, P., Miller, J., Demetrion, G., & Lew, S. (1995). Clotting by heparin of hemoaccess for hemodialysis in an end-stage renal disease patient. American Journal of Kidney Diseases, 25 (4). http://dx.doi.org/10.1016/0272-6386(95)90138-8