High plasma endostatin level unaffected by low-molecular weight heparin in hemodialysis patients--a preliminary report.

PURPOSE Endostatin (ES) is a potent inhibitor of angiogenesis and neoangiogenesis, and interestingly its activity is modified by heparin. To understand if low-molecular weight heparins have different clinical profiles regarding this cytokine, we studied the effects of enoxaparin, nadroparin and dalteparin administered for hemodialysis (HD) anticoagulation on plasma ES levels. MATERIAL AND METHODS Seventeen chronic HD patients completed this prospective, crossover trial. They were randomized into 6 groups - each patient was administered enoxaparin (effective dose of 0.75 mg/kg), nadroparin (70.4 IU/kg) and dalteparin (78.6 IU/kg) in 3 time periods of 2 months each. At the end of each period plasma levels of ES were measured at the start and at 10 min and 180 min of the HD procedure. RESULTS Mean predialysis plasma ES levels in HD patients were extremely high for all three heparins used. We observed no changes in ES levels during dialysis, there were also no differences in ES profiles for each of the low-molecular weight heparins used. CONCLUSIONS Plasma ES levels are unusually high in chronic HD patients and the significance of this fact needs future research. ES levels do not change after heparin administration and at least in that aspect enoxaparin, nadroparin and dalteparin are equal.