Detection and Scoring of Extracorporeal Circuit Clotting During Hemodialysis

Semin Nephrol. 2023 Nov;43(6):151474. doi: 10.1016/j.semnephrol.2023.151474. Epub 2024 Jan 24.


Maintaining patency of the extracorporeal hemodialysis (HD) circuit is a prerequisite to perform HD. Unfractionated heparin and low-molecular-weight heparins are the most used anticoagulants in maintenance HD, but their administration comes with a major trade-off of bleeding complications. This narrative review article discusses technical factors impacting on HD circuit patency, such as tubings, dialyzer membranes, priming practices, and treatment settings. Strategies for monitoring extracorporeal circuit clotting during and after treatment are also reviewed, as these are essential tools for optimizing anticoagulation.

Keywords: Hemodialysis; clotting; micro-CT; thrombin.

Publication types

  • Review

MeSH terms

  • Anticoagulants* / therapeutic use
  • Blood Coagulation
  • Heparin
  • Humans
  • Renal Dialysis* / methods


  • Anticoagulants
  • Heparin