Heparin-free hemodialysis (HD) is not significantly associated with decreased likelihood of death, bleeding or thrombosis, new findings show. The finding suggests that HD without heparin may be no safer than HD with heparin, researchers concluded.

Jenny I Shen, MD, and colleagues at the Stanford University School of Medicine in Palo Alto, Calif., identified 12,468 patients aged 67 years or older with no recent history of warfarin use who initiated maintenance HD from 2007-2008. Of these patients, 836 (6.7%) were dialyzed without heparin. In multivariable-adjusted analyses, a history of gastrointestinal bleeding, hemorrhagic stroke and lower hemoglobin and platelet counts were associated with higher odds of heparin-free HD.

The researchers found no significant difference between heparin-free HD and HD with heparin with respect to all-cause mortality, bleeding, atherothrombosis, or venous thromboembolism, according to findings published online ahead of print in Nephrology Dialysis Transplantation.

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In addition, results showed that heparin-free HD varied by as much as fourfold by dialysis facility region.