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Heparin vs. Fibrin | Spoilers: Heparin Wins

The other morning, I looked at my cycler after I had finished draining, and there was -67 ultra-filtration (UF). UF is the measurement of how much fluid you have taken off during dialysis. My UF is usually somewhere around 900 to 1000, so I decided to attack the most likely culprit, fibrin, with its mortal enemy, heparin.

Fibrin is a white jellyfish-like substance that sometimes comes out in the drain while doing peritoneal dialysis. As I understand it, it can also wrap itself around your catheter inside your abdomen, causing a slow drain, as well as seep into your catheter causing a slow drain. In technical terms, “fibrin… is a fibrous, non-globular protein involved in the clotting of blood.” (https://en.wikipedia.org/wiki/Fibrin) So it is usually a good thing, but not when you are trying to drain a bellyful of dialysate solution.

When I am having trouble draining, my dialysis nurse taught me to look for constipation or fibrin. Since I was still having regular bowel movements, I decided that fibrin was the most likely culprit, so I sentenced it to death by heparin. As I understand it, heparin, an anticoagulant, dissolves fibrin. Goodbye fibrin!

During peritoneal dialysis, heparin is administered by injecting it into the bags of dialysate solution so that it will go into your abdominal cavity when you fill. During my training for PD, my nurse told me to use Betadine as an antiseptic to disinfect the top of the heparin bottle as well as the injection ports on the bags of dialysate solution. I leave it there for five minutes to do its thing, and then I wipe it with a sterile piece of gauze and clean it with an alcohol wipe. Then I can fill up a hypodermic needle with heparin and inject it into the bags. Because I am using the 5 liter bags for the cycler, I  inject 2 ml of heparin into each bag.

I am now draining fine. I don’t have to use heparin regularly, just when I see fibrin in my drains or I get a blocked drain. As I have been on PD now for three years, I have a pretty good idea of when I need to use heparin, but I have seen on board posts that some people have to use it weekly or even nightly. Everyone experiences dialysis differently, so it is important to always consult your dialysis nurse or nephrologist if you have any questions.

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