Usually prolonged heparin-free dialysis is bad, affecting the adequacy of dialysis, increasing the risk of coagulation, worsening anemia, and clogging dialysis lines.
Heparin-free dialysis is suitable for those with active bleeding, high bleeding risk, and contraindications to heparin.
Normal use of anticoagulant dialysis time is 4h / times, heparin-free dialysis will lead to shorter dialysis time, uremic toxin removal is not adequate, prolongation of time increases the risk of coagulation, resulting in interruption of dialysis, loss of red blood cells, etc. aggravate renal anemia, in addition to possible clogging of dialysis lines, affecting the follow-up of dialysis and so on.
Patients with contraindications to heparin use can use citrate anticoagulation, heparin pre-flush (heparin-induced thrombocytopenia is contraindicated), high blood flow dialysis, and saline flushing every 15-30 min during dialysis, but it will increase the water load.
For maintenance hemodialysis patients, it is recommended to communicate with the doctor of the dialysis center where they are located, who will give an individualized anticoagulation and dialysis plan according to the specific situation.