Table 1.

Sample Dosing Schedules for UFH for Anticoagulation During Long-term Hemodialysis

Loading Dose	Maintenance Infusion	Parameters for Adjustment
	Standard Protocols
25 IU/kg	1,000 IU/h Stop 30-60 min before end of treatment	If excessive bleeding or clotting occurs, adjust maintenance infusion by 500 IU/h
2,000 IU	None	If excessive bleeding or clotting occurs, adjust loading dose by 500 IU If clotting persists with loading dose ≥4,500 IU, add second bolus dose or start maintenance infusion
	Low-Dose Protocols
10 IU/kg	10 IU/kg/h Stop 30-60 min before end of treatment	If excessive bleeding occurs, eliminate loading dose If bleeding persists or clotting occurs, adjust maintenance infusion by 500 IU/h
25 IU/kg	None	If excessive bleeding occurs, decrease loading dose by 5 IU/kg If clotting occurs, add second bolus dose (50% of first bolus) or start maintenance infusion

Note: The authors recommend the first protocol for all patients. Alternative protocols from the literature are listed; there is no evidence favoring one protocol over another. Standard protocols are appropriate for most patients. Low-dose protocols have been suggested for patients with an increased risk of bleeding.^16,28,29

Abbreviation: UFH, unfractionated heparin.