Abstract: . . .  A, Boesken WH. Continuous haemofiltration with r-hirudin (lepirudin) as anticoagulant in a patient with heparin induced thrombocytopenia (HIT II). Wien Klin Wochenschr 2000; 112(12): 552-5. 8. Whelen S, Carr ME Jr. Use of recombinant hirudin in heparin-induced thrombocytopenia and thrombosis (HITT) and renal failure: a case report. angiology 2001; 52(10): 711-5. 9. Nowak G, Bucha E, Brauns I, Czerwinski R. Anticoagulation with r- hirudin in regular haemodialysis with heparin-induced thrombocytopenia (HIT II). The first long-term application of r-hirudin in a haemodialysis patient. Wien Klin Wochenschr 1997; . . .
. . .  was readmitted to our hospital because of an acute substernal pain with electrocardiogram findings suggestive of acute myocardial infarction. On clinical examination an intense oedema with pain and redness on her right forearm was noticed. A duplex ultrasound study revealed thrombosis in the right subclavian vein. The laboratory tests were as follows: haemoglobin 7.1g/dl, white cell count 22.5x10 9 /l (neutrophils 88%, lymphocytes 8%, monocytes 4%), platelets 45x10 9 /l, coagulation tests were normal except for the presence of elevated D-Dimers, urea 38.5mmol/l (normal range . . .
. . .  Schneider T, Heuer B, Deller A, Boesken WH. Continuous haemofiltration with r-hirudin (lepirudin) as anticoagulant in a patient with heparin induced thrombocytopenia (HIT II). Wien Klin Wochenschr 2000; 112(12): 552-5. 8. Whelen S, Carr ME Jr. Use of recombinant hirudin in heparin-induced thrombocytopenia and thrombosis (HITT) and renal failure: a case report. angiology 2001; 52(10): 711-5. 9. Nowak G, Bucha E, Brauns I, Czerwinski R. Anticoagulation with r- hirudin in regular haemodialysis with heparin-induced thrombocytopenia (HIT II). The first long-term application of r-hirudin in a haemodialysis patient. Wien . . .
. . .  doses as low as 0.005mg/kg have been advocated in anuric patients. Recovering renal function however, can lead to the need for drastically increased doses. 10 In our patient, intermittent intravenous administration of lepirudin once daily according to APTT values for forty days was effective. After commencing lepirudin the patient didnt experience any other thrombotic episode, haemodialysis sessions were uneventful and bleeding did not occur. It was surprising that partial recanalization of the right renal artery was gradually restored with the right kidney regaining partial function allowing the . . .
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