Heparin has been used with success as the main anticoagulant in standard dialysis treatments. Although alternative approaches such as Regional Citrate Anticoagulation (RCA) and saline flushes have attempted to prevent blood from coagulating, the use of heparin remains the most safe and efficient method for preventing anticoagulation in the extracorporeal dialysis circuit.
Nevertheless, heparin may be avoided as an active treatment strategy for patients that suffer from acute bleeding episodes. In addition, one may also decide to elect a prevention strategy and avoid all kinds of heparins for all patients that have at least a high or a medium risk for bleeding or an elevated cardiovascular risk due to deranged lipid profiles.
Our unrivaled option: heparinize the membrane and not the patient!
This innovation is enabled by a specialized surface treatment of the AN69ST membrane with polyethyleimine (PEI) on both dialysate and blood sides of the Nephral ST dialyser. During priming with a pre-heparinized solution, the electronegative heparin contained in the priming solution forms an ionic bond with the membrane's electropositive PEI.
The heparin molecules adhere to the membrane and remain safely bound to it throughout the dialysis session thus providing anticoagulation effect without heparin being metabolized by the body. Therefore, less systemic heparin may be given to your patient during the dialysis session reducing the risks* associated with regular systemic heparin administration.
Treating high bleeding risk patients with Nephral ST in a complete systemic heparin-free treatment is the most comfortable option for these patients and massively decreases the workload for the caregiver compared to other techniques like saline flushes or Regional Citrate Anticoagulation.
* Bleeding, Heparin-induced deranged lipid profiles such as hyperlipidaemia, dyslipidaemia or cholesterol embolism, osteoporosis, Heparin-induced thrombocytopenia and Heparin-induced hyperkalaemia and hypernatraemia.
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