Concomitant use of argatroban and warfarin during hemodialysis in heparin-induced thrombocytopenia

Hematology. 2015 Jan;20(1):48-9. doi: 10.1179/1607845414Y.0000000157. Epub 2014 Feb 28.

Abstract

Objective and importance: The use of argatroban during hemodialysis in a patient receiving warfarin is not established. We present a case of heparin-induced thrombocytopenia in a patient on hemodialytic therapy who successfully received argatroban concomitantly to warfarin during renal replacement therapy.

Clinical presentation: A 46-year-old male patient with autosomal dominant polycystic kidney disease presented with heparin-induced thrombocytopenia (HIT) arised during dialytic procedures. Intervention After the acute episode requiring argatroban and warfarin therapy, the patient continued to receive argatroban during the hemodialytic session concomitantly to warfarin.

Conclusion: The administration of argatroban in the dialytic circuit of a patient on oral anticoagulant therapy can be considered an effective and safe approach.

Keywords: Argatroban; Hemodialysis; Heparin-induced thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / administration & dosage*
  • Arginine / analogs & derivatives
  • Heparin / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Pipecolic Acids / administration & dosage*
  • Polycystic Kidney Diseases / blood
  • Polycystic Kidney Diseases / therapy
  • Renal Dialysis / methods*
  • Sulfonamides
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / drug therapy*
  • Warfarin / administration & dosage*

Substances

  • Anticoagulants
  • Pipecolic Acids
  • Sulfonamides
  • Warfarin
  • Heparin
  • Arginine
  • argatroban