ABSTRACT
Because unfractionated heparin (UFH) is the major anticoagulant in hemodialysis (HD), it is important to define the potential role of heparin-induced thrombocytopenia (HIT) in contributing to morbidity and mortality in patients with dialysis-dependent renal failure. Of 154 patients newly treated with HD, 6 (3.9% ) were clinically suspected ofhaving developed HIT because of a fall in the platelet count accompanied by clotting of the dialyzer and extracorporeal circuit (Yamamoto et aI., 1996). The clinical diagnosis was confirmed by the detection ofHIT antibodies in all but one patient. Only one patient developed organ damage from thrombosis (myocardial infarction and stroke). All six patients were switched to an alternative anticoagulant and did not suffer from thromboembolic events in the follow-up period. Compared with the incidence of HIT of 2.7% found in 332 hip surgery patients treated with UFH (Warkentin et aI., 1995), the incidence ofHIT in acute hemodialysis patients thus appears to be similar, regardless of the underlying cause of renal dysfunction (Finazzi and Remuzzi, 1996).
