Avoiding Systemic Heparinization During Hemodialysis: How the Dialysis Setup Might Help

Heparin is the most widely used anticoagulant for maintaining patency of the extracorporeal blood circuit during intermittent hemodialysis. Inadvertently, this leads to systemic heparinization of the patient. Repeated intermittent heparinization during hemodialysis has been associated with increased bleeding risks and metabolic and immunologic effects. Alternative strategies for minimizing systemic anticoagulation encompass dilution methods, regional citrate anticoagulation, priming of the extracorporeal circuit, and modifications to dialyzer membranes and dialysate composition. The effectiveness of these alternatives in maintaining patency of the extracorporeal circuit varies substantially. Although most studies have focused on particular changes in the hemodialysis setup, several combined interventions for adapting the hemodialysis setup are now being studied. This narrative review aims to present an overview of the current landscape of hemodialysis setup strategies aimed at limiting or avoiding systemic anticoagulation during treatment. Additionally, this review intends to shed light on the underlying pathophysiological mechanisms that contribute to variations observed in reported outcomes.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed research on safety and infection-control considerations relevant to leech therapy and anticoagulation. Indexed in PubMed and verified against the NCBI record.

Узнайте, как это исследование связано с клинической практикой

More peer-reviewed studies in Безопасность и инфекционный контроль.

• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• Bacterial symbioses of the medicinal leech Hirudo verbana — Nelson M, Graf J (2012)
• Leech related Aeromonas complex infection after reconstruction with a microvascular forearm flap — Beger B, von Loewenich F, Goetze E, Moergel M, Walter C (2016)
• Aeromonas septicemia after medicinal leech use following replantation of severed digits — Levine SM, Frangos SG, Hanna B, Colen K, Levine JP (2009)
• Outcomes of flap salvage with medicinal leech therapy — Nguyen MQ et al. (2012)
• The role of leech water sampling in choice of prophylactic antibiotics in medical leech therapy — Wilmer A et al. (2013)
• The development and application of mini-barcodes from mitochondrial DNA for identifying medicinal leeches from traditional medicines — Liu Y et al. (2025)

Browse all ASH-analysed research →