Pharmacokinetics of Certoparin During In Vitro and In Vivo Dialysis

The efficacy and safety of certoparin in the prophylaxis of clotting during hemodialysis have recently been proven. Different to other low‐molecular weight heparins (LMWHs), certoparin does not accumulate in maintenance dialysis patients for unknown reasons. The purpose of the present study was to e...

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Bibliographic Details
Published in:Artificial organs 2015-11, Vol.39 (11), p.951-959
Main Authors: Krieter, Detlef H., Fink, Susanne, Dorsch, Oliver, Harenberg, Job, Melzer, Nima, Wanner, Christoph, Lemke, Horst-Dieter
Format: Article
Language:English
Subjects:
Adult
Aged
Anticoagulants - pharmacokinetics
Bioaccumulation
End-stage renal disease
Enoxaparin - pharmacokinetics
Experiments
Female
Hemodialysis
Hemofiltration
Heparin - pharmacokinetics
Heparin, Low-Molecular-Weight - pharmacokinetics
Humans
In Vitro Techniques
Low-molecular weight heparin
Male
Middle Aged
Molecular weight
Renal Dialysis
Unfractionated heparin
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Summary:The efficacy and safety of certoparin in the prophylaxis of clotting during hemodialysis have recently been proven. Different to other low‐molecular weight heparins (LMWHs), certoparin does not accumulate in maintenance dialysis patients for unknown reasons. The purpose of the present study was to examine the impact of the dialysis procedure on the removal of certoparin. In a subgroup of the MEMBRANE study consisting of 12 patients, the pharmacokinetics of certoparin during hemodialysis was determined by means of the anti‐Xa activity. In addition, the elimination of certoparin into continuously collected dialysate was assessed. Further, in vitro experiments with human blood‐simulating high‐flux hemodialysis and hemofiltration were performed to quantify the elimination and the sieving coefficients SK of the two LMWHs certoparin and enoxaparin compared with unfractionated heparin (UFH). The surrogate marker middle molecules inulin and myoglobin served as reference solutes during the experiments. Finally, the adsorption of 125iodine‐radiolabeled certoparin onto the synthetic dialysis membrane was quantified. The clinical study reconfirmed the absence of bioaccumulation of certoparin with anti‐Xa activities between 
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.12475