Treatment of Acute HIT in Patients Receiving Renal Replacement Therapy

Patients with acute heparin-induced thrombocytopenia who are on renal replacement therapy require anticoagulation to keep the dialysis circuit patent — yet heparin itself must be avoided. Selecting the right alternative anticoagulant in this situation is a distinct clinical decision.

Clinical scenario

Acute HIT, receiving renal replacement therapy, requiring anticoagulation to prevent thrombosis of the dialysis circuitry.

Treatment approach

The recommended approach centres on choosing among a defined set of specific non-heparin anticoagulants suited to this setting — the full protocol details which agents are indicated, how they compare, and the evidence behind the recommendation.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1182/bloodadvances.2018024489

In patients with acute HIT who are receiving renal replacement therapy and require anticoagulation to prevent thrombosis of the dialysis circuitry, the ASH guideline panel suggests treatment with argatroban, danaparoid, or bivalirudin rather than other non-heparin anticoagulants (conditional recommendation; very low certainty in the evidence about effects).

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