Effectiveness of unfractionated heparins versus low-molecular-weight heparins for the prevention of coagulation in patients with renal insufficiency undergoing hemodialysis.

Abstract

Objective: A systematic review of ten scientific articles was conducted, with a publication date of less than ten years, from the following databases: Scielo, Pubmed, Epistemonikos, Medline, and Google Scholar. Of the selected articles, 20% were systematic reviews and meta-analyses, 40% were randomized clinical trials, 20% cohort studies, and 20% case-control studies. The overall quality of evidence was high in 70% of the articles and moderate in 30%. The studies originated from the following countries: USA (30%), Canada (20%), Brazil (10%), Austria (10%), Israel (10%), Poland (10%), and the UK (10%). The GRADE system was used to identify the level of evidence. Results: According to the findings, 60% (n = 6/10) indicated that both heparins are equally effective in preventing coagulation in patients with renal failure undergoing hemodialysis. 30% (n = 3/10) suggested that low-molecular-weight heparin is more effective than unfractionated heparin, and 10% (n = 1/10) indicated that unfractionated heparin is more effective than low-molecular-weight heparin. Conclusions: Unfractionated heparin is as effective as low-molecular-weight heparin in preventing coagulation in patients with renal failure undergoing hemodialysis treatment.

Se realizo una revisión sistemática de diez artículos científicos, con antigüedad menor a diez años en las bases de datos: Scielo, Pubmed, Epistemonikos, Medline, Google academic.Correspondiendo 20% a revisiones sistemáticas y metaanalisis, 40% en ensayos clínicos aleatorizados, 20% de estudios de cohortes y 20% estudios caso control. Teniendo una calidad de evidencia alta en 70 % y media 30%. Los estudios pertenecen a los países de USA (30%), Canadá (20%), Brasil (10%), Austria (10%), Israel (10%), Polonia (10%) y U.K (10%). Se utilizó el sistema grade para identificar el grado de evidencia. Resultados: De acuerdo a los resultados obtenidos, 60% (n = 6/10) indican que ambas heparinas son igual de efectivas para la prevención de la coagulación en pacientes con insufisiencia renal sometidos a hemodiálisis. 30 % (n = 3/10) Indican que la heparina de bajo peso molecular es más efectiva que la heparina no fraccionadas y finalmente 10% (n = 1/10) indican que las heparinas no fraccionadas son más efectiva que la heparina de bajo peso molecular. Conclusiones: La heparina no fraccionada, es tan efectiva como la heparina de bajo peso molecular, para prevenir la coagulación en pacientes con insuficiencia renal sometidos al tratamiento de hemodiálisis.