SynthesisBMC nephrology2017
Safety of low-molecular-weight heparin compared to unfractionated heparin in hemodialysis: a systematic review and meta-analysis.
Synthesis in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 5 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Anticoagulation for people receiving long-term haemodialysis.The Cochrane database of systematic reviews · 2024Pooled it
- Executive summary of the Korean Society of Nephrology 2021 clinical practice guideline for optimal hemodialysis treatment.The Korean journal of internal medicine · 2022Guideline
- Korean Society of Nephrology 2021 Clinical Practice Guideline for Optimal Hemodialysis Treatment.Kidney research and clinical practice · 2021Guideline
- Renal Association Clinical Practice Guideline on Haemodialysis.BMC nephrology · 2019Guideline
- Pooled it
- Analysis of clinical pharmacist interventions in the neurology unit of a Brazilian tertiary teaching hospital.PloS one · 2019Trial
- Biomechanical anticoagulation by spherical platelets in extracorporeal systems.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- An Overview of Anticoagulant Drugs Pharmacology, Therapeutic Approaches, Limitations and Perspectives.Pharmaceutics · 2026Review
- Molecular biomarkers in dialysis-related thrombosis and anticoagulation monitoring: thrombin-antithrombin complex, plasmin-α2-antiplasmin complex, soluble thrombomodulin, tPA/PAI-1/tPAIC, and Anti-Xa.Frontiers in medicine · 2026Review
- Observational
- The Application of Regional Citrate Anticoagulation in Protein A Immunoadsorption: A Single-Center Retrospective Cohort Study.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2024Article
- Ten tips to manage oral anticoagulation in hemodialysis patients with atrial fibrillation.Clinical kidney journal · 2024Review
- Association between anticoagulation strategy and quality of life in chronic hemodialysis patients.Scientific reports · 2023Observational
- Anti-Xa level monitoring of low-molecular-weight heparin during intermittent venovenous hemofiltration.Annals of hematology · 2023Observational
- Not Just Anticoagulation-New and Old Applications of Heparin.Molecules (Basel, Switzerland) · 2022Review
- Article
- Review
- Quality improvement project to enhance heparin safety in patients with haemodialysis in China.BMJ open quality · 2022Article
- Pharmacokinetic, Hemostatic, and Anticancer Properties of a Low-Anticoagulant Bovine Heparin.TH open : companion journal to thrombosis and haemostasis · 2022Article
- Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS.BMC nephrology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow molecular weight heparins (LMWH) have been extensively studied and became the treatment of choice for several indications including pulmonary embolism. While their efficacy in hemodialysis is considered similar to unfractionated heparin (UFH), their safety remains controversial mainly due to a risk of bioaccumulation in patients with renal impairment. The aim of this systematic review was to evaluate the safety of LMWH when compared to UFH for extracorporeal circuit (ECC) anticoagulation.
methodsWe used Pubmed, Embase, Cochrane central register of controlled trials, Trip database and NICE to retrieve relevant studies with no language restriction. We looked for controlled experimental trials comparing LMWH to UFH for ECC anticoagulation among end-stage renal disease patients undergoing chronic hemodialysis. Studies were kept if they reported at least one of the following outcomes: bleeding, lipid profile, cardiovascular events, osteoporosis or heparin-induced thrombocytopenia. Two independent reviewers conducted studies selection, quality assessment and data extraction with discrepancies solved by a third reviewer. Relative risk and 95% CI was calculated for dichotomous outcomes and mean weighted difference (MWD) with 95% CI was used to pool continuous variables.
resultsSeventeen studies were selected as part of the systematic. The relative risk for total bleeding was 0.76 (95% CI 0.26-2.22). The WMD calculated for total cholesterol was -28.70 mg/dl (95% CI -51.43 to -5.98), a WMD for triglycerides of -55.57 mg/dl (95% CI -94.49 to -16.66) was estimated, and finally LDL-cholesterol had a WMD of -14.88 mg/dl (95% CI -36.27 to 6.51).
conclusionsLMWH showed to be at least as safe as UFH for ECC anticoagulation in chronic hemodialysis. The limited number of studies reporting on osteoporosis and HIT does not allow any conclusion for these outcomes. Larger studies are needed to evaluate properly the safety of LMWH in chronic hemodialysis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.