Background: Anticoagulants such as unfractionated heparin (UH) and low-molecularweight heparin (LMWH) are indispensable to the performance of hemodialysis, but it has been suggested that long-term heparin administration affects bone metabolism and may cause heparin-induced osteoporosis. On the other hand, renal failure patients are known to develop secondary hyperparathyroidism as a result of abnormal calcium and phosphorus metabolism, vitamin D deficiency, etc., and to have bone metabolism abnormalities due to renal osteodystrophy. Although LMWH has been reported to have less of an effect on bone metabolism than UH does, the effects of LMWH and UH on the bones of renal failure patients have not been adequately studied. Objective: To investigate the effects of LMWH and UH on bone metabolism under renal failure conditions by using bone morphometry methods in renal failure rats. Methods: Seven-week-old male Sprague-Dawley rats were 5/6-nephrectomized and randomized to receive LMWH (1000 U/kg: group L), UH (1000 U/kg: group H) or no treatment (group Nx). Sham-operated rats of the same strain and age served as normal controls. After 8 weeks, the rats were killed and blood biochemistry and morphologic changes in the femoral secondary substantia spongiosa were examined. Results: All of the renal failure rats had elevated blood parathyroid hormone (PTH) levels. Bone morphometry revealed lower bone formation parameters in both the H group and the L group than in the Nx group, and they were markedly lower in the H group. In addition, the bone resorption parameters tended to be lower in both the H group and the L group than in the Nx group. Conclusions: Both UH and LMWH inhibited bone formation in the presence of elevated blood PTH levels, and they did not promote bone resorption. In addition, the effects of LMWH were milder than those of heparin, and it seemed to have less effect on bone metabolism. Because the results suggested the possibility that both UH and LMWH either directly or indirectly inhibit bone metabolic turnover in renal failure by some sort of mechanism of action, further study will be necessary in the future.
|Original language||English (US)|
|Number of pages||6|
|Journal||Journal of the Wakayama Medical Society|
|State||Published - Sep 1 2009|
- Low-molecular-weight heparin (LMWH)
- Renal failure
ASJC Scopus subject areas