Table 6.

Recommended anticoagulants for dialysis patients^6,112

Anticoagulants	Dosages	Advantages	Disadvantages
Unfractionated heparin	5–15 IU/kg (initial) 5–10 IU/kg per hour (continuous)	Ease to use and could be reversed by protamine with a short half-life and lower cost	May induce bleeding, hypertriglyceridemia, HIT, osteoporosis, and hyperkalemia
Regional heparin with protamine	Heparin prefilter: 1000–1500 U/h Protamine postfilter: 10–12 mg/h	Lower risk of bleeding	Complexity in administration and high cost
Enoxaparin	0.15 mg/kg (initial) 0.05 mg/kg per hour (continuous)	Lower risk of HIT	Lacking reversal agent, resulting in bioaccumulation risk. Higher cost
Dabigatran	15–25 IU/kg (initial) 5 IU/kg per hour (continuous)
Argatroban	0.1 mg/kg (initial) 0.05–0.2 mg/kg per minute (continuous)	Can be used in patients with HIT	With a narrow therapeutic window and bleeding and anaphylaxis risk.113 Lacking reversal agent114
Bivalirudin	2 mg/h
RCA	Infused to achieve a citrate blood concentration of 3–4 mmol/L	Lower risk of bleeding and may improve inflammatory profile	Might cause metabolic acidosis because of citrate accumulation. Needing calcium monitoring

HIT, heparin-induced thrombocytopenia; RCA, regional citrate anticoagulation.