Retrospective use of heparin for VTE prophylaxis in adult patients on hemodialysis

Abstract

Background: There is minimal research on whether heparin 5000 units subcutaneous (Sub-q) should be dosed every 8 hours versus every 12 hours in hemodialysis (HD) patients for venous thromboembolism (VTE) prophylaxis. Methods: Management of the research data for this study involved collection, entry, processing, storage, retrieval, archival, distribution and documentation of information collected according to a written protocol. Efficacy and safety were measured using a Fisher’s exact test with a two-tailed p-value. A p-value of less than 0.05 was considered significant. Study population : An EPIC report was obtained for hemodialysis patients that received heparin 5000 units Sub-q every 8 hours or every 12 hours from March 13, 2014 to April 28, 2020. 4303 patients were included, and 273 patients were assessed for eligibility. 214 patients were analyzed. Results: The primary endpoint–vascular event, ischemic event, death related to coagulopathy, anaphylaxis, hyperkalemia, hypertriglyceridemia, heparin induced thrombocytopenia (HIT), or sepsis in patients receiving heparin who were on HD occurred in 12 of 107 patients (11.2%) in the heparin 5000 units Sub-q every 8 hours group and 10 of 107 patients (9.3%) in the heparin 5000 units Sub-q every 12 hours group (p=0.676). Conclusion : In HD patients on heparin for VTE prophylaxis, we detected no statistically significant difference between heparin 5000 units Sub-q every 8 hours versus every 12 hours.