Influence of thromboembolism prophylaxis by low molecular weight heparin CY 216 (fraxiparine®) on several parameters of haemostasis in patients under dialysis and receiving either unfractionated heparin or CY 216

The hemorragic risk of an association of the low molecular weight (LMWH), Fraxiparine® injected intravenously at the dose of 7.500 AXaICU or of unfractionated heparin (UFH) injected intravenously at the usual dose used during hemodialysis (3.750 ± 1.280 IU + 1.000 IU after 2 hours of dialysis) to the subcutaneous administration once daily of a thromboembolism preventive dose of Fraxiparine (7.500 AXaICU) was evaluated on the modification of the following hemostasis parameters : thrombin time, activated partial thromboplastin time (APTT), anti Xa activity, in 13 uremic patients on hemodialysis. The association of intravenous and subcutaneous Fraxiparine prevented efficiently the clotting of the extracorporeal circulation without inducing a detectable antithrombinic activity. In contrast, the association of I.V. UFH to subcutaneous Fraxiparine induced a significant increase of the thrombin time and of the APTT, so explained by the activity of UFH. It is concluded that subcutaneous Fraxiparine at the thromboembolism preventive dose can be associated as well to I.V. Fraxiparine as to UFH without increasing the potential hemorrhagic risk. Nevertheless the association of SC and IV Fraxiparine 7 500 AXaIC u seems preferable to the association of SC Fraxiparine with UFH.