Heparin: Yes or no?

[dac0214]

Since I've started dialysis, I've noticed that I bruise very easily, and often when I remove the band-aids the next day, they will still bleed a bit. I assume that Heparin is the cause of this. I've also heard that some people can dialyze without the benefits (and side-effects) of Heparin, instead by flushing every hour with saline. Since I am already at minimal fluid reduction and flush at least once each treatment with at least 100ml of saline (to reduce leg cramps), perhaps I can go completely without Heparin?

Does anybody else do this?

[stumpr54]

Hello dac0214,

I've never used Heparin in my short daily treatments - never had a problem with blood flows or clotting lines or cartridge. When I started nocturnal treatments, I used a Heparin pump and then changed to a Heparin bolus at the start of treatment. After forgetting the Heparin bolus for a few treatments, I realized that I could run effectively without it.

My platelet count (along with mild anemia) had been historically low, though after a year or so on HHD it has come back to the normal range. In spite of a normal range for my platelets, I still don't have issues with running without Heparin.

I've never experienced post treatment bleeding, in fact I can remove my band-aids 20 to 30 minutes or so after a treatment and shower without fear of bleeding. I believe that the button hole access contributes to this, with an established tract (tunnel) that precedes the fistula flap, aids the clotting process.

During the first year or so on HHD, I did periodically experience prolonged clotting (pressure holds of 25 to 30 minutes) times. This may have been attributed to the low platelet count, my hold technique, or the newness of my fistula and button hole sites. During the past 1-2 years, my pressure holds have consistently been in the 14 to 18 minute range, regardless of button hole site, e.g. sites closer to the anastomosis clot in the same time as those much farther away.

I suggest that you try to treat without Heparin and see if and how your treatments are affected.

[dac0214]

I've been going without Heparin for 2 treatments so far. I just add 300 ml to the UF amount they take off, then have them flush 100 ml at the 1 hr, 2 hr, and 3 hr marks. So far, it's been working well.

[retiredas5]

I don't use Heparin because I have low Platelet and I bleed for 30 mins after pulling the needles. My Dialysis center found the cure for bleeding, called (Sure seal), in two mins the bleeding is stopped. you can find them online. It is a pressure type band aid. hope this helps.

[retiredas5]

I don't use Heparin because I have low Platelet and I bleed for 30 mins after pulling the needles. My Dialysis center found the cure for bleeding, called (Sure seal), in two mins the bleeding is stopped. you can find them online. It is a pressure type band- aid. hope this helps.

[dac0214]

FWIW, after about 3 months, I went back on Heparin, but at a lower dose (bolus of 2.0 @ start, then .5/hour, stopping 1 hr. before end of dialysis). So far, so issues. I also have a low platelet count.