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Lipid disorder is a well-known problem in hemodialysis (HD) patients. This condition is an important risk factor for cardiovascular disease. Although a positive effect of low molecular weight heparin (LMWH) upon lipid profile has been proposed in HD patients, this consequence is still controversial. Furthermore, HD patients are exposed to chronic inflammation that is also known as a risk factor for cardiovascular disease. In this study, we compared the effect of LMWH and standard heparin (SH) on lipid profile and Creactive protein that is one of the inflammation markers.
In this prospective, randomized, and cross-over study, 30 HD patients were enrolled in the study. They were randomly divided into two groups. SH was administered to group I and LMWH was administered to group II. Blood samples were drawn before HD sessions at the beginning, eight weeks before and after switching the therapy. The study was finished at the sixteenth week. Lipid profile, high sensitivity-CRP and albumin were determined.
Serum lipid parameters and serum albumin levels, which were determined at the beginning, before and after switching the therapy, were not significantly changed (p>0.05). However, CRP was significantly reduced in patients treated with LMWH before and after switching therapy (p<0.05).
Neither LMWH nor SH has an effect upon serum lipid and albumin levels. More than two months may be required to cause significant changes in lipid profile and serum albumin levels in HD patients. However, we demonstrated a decrease in the inflammation, which is responsible for the cardiovascular morbidity and mortality, independently from the serum lipid and albumin levels. Although long-term studies are warranted, our results indicate that LMWH should be preferred for anticoagulation in HD patients due to its beneficial effects upon inflammation.