Low Molecular Weight Heparin-Induced Thrombocytopenia: A Case Series Study of Newly Admitted Hemodialysis Patients

Low molecular weight heparin (LMWH), a common anticoagulant in hemodialysis, can cause the dangerous condition of heparin-induced thrombocytopenia (HIT) in rare cases. The present study reviews five cases of HIT diagnosed in our center, which treats more than 400 maintenance hemodialysis patients annually over a 30-year period. All five cases occurred in incident patients who were being exposed to LMWH for the first time. Treatment involved stopping LMWH and using alternative anticoagulants. Both the 4Ts score and antibody tests were used to confirm the diagnosis of HIT. Following diagnosis, close monitoring was performed for 10–15 days in typical cases or 30 days in severe cases until blood platelet levels recovered to near normal values. Our results suggest that while uncommon, HIT associated with use of LMWH can occur in hemodialysis patients, especially when patients are being exposed to this anticoagulant for the first time.