Comparison of using fractionated and unfractionated heparins after primary hip and knee arthroplasty in patients receiving programmed hemodialysis

INTRODUCTION. The risk of femoral neck fractures in hemodialysis patients is estimated at 25.6 per 1000 people per year. Hip arthroplasty is the treatment choice in these patients. One of the causes of general somatic complications is the significantly more frequent formation of blood clots. PATIENTS AND METHODS. The material for the study was data on 96 hemodialysis patients who underwent primary hip arthroplasty in the period from 2016 to 2019. THE AIM. Сomparison of various algorithms for the use of fractionated and unfractionated heparins after primary hip and knee arthroplasty in patients receiving programmed hemodialysis. RESULTS. The largest number of thrombosis was noted in group 1 (heparin was used only during hemodialysis procedures): in 4 patients (16.6 %), in group 4 (using fractionated heparin both during hemodialysis procedures and on interdialysis days): in 2 patients (8 %). When comparing the volume of the evacuated hematoma, the statistically significant volume was in group 2 (with the use of un fractionated heparin both during dialysis and on interdialysis days), on average 98 ± 52 ml. In the same group, the greatest number of infectious complications was noted: in 5 patients (21.8 %); in group 4: in 2 patients (8 %). CONCLUSION. Conducting thromboprophylaxis in hemodialysis patients after arthroplasty of major joints with fractionated heparins, both during the hemodialysis procedure and on interdialysis days, can reduce the number of thromboembolic complications to 8 % (16.6 % with the traditional method). Affect on the volume of blood loss and blood transfusion not statistically significant. At the same time, there is a significant decrease in the level of potassium by 8.8 %, total cholesterol by 7.3 %, triglycerides by 11.7 % with the daily use of fractionated heparins.

arthroplasty of the hip and knee joints, programmed hemodialysis, thromboprophylaxis

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