Anti-coagulants during hemodialysis: Can they cause hair loss?

Blood Thinners and Hair Loss

Dialysis is a medical procedure used to filter waste from the blood in patients with kidney disease. Close to 500,000 Americans and 25,000 Canadians are receiving dialysis. The most common reasons for dialysis is end stage kidney disease due to diabetes and high blood pressure. 

Hair loss and hair changes occur time to time in patients receiving dialysis. One needs to consider a range of nutritional issues (including protein intake, zinc deficiency, iron deficiency), thyroid abnormalities, as well as hair loss from systemic disease itself (ie. autoimmune disease). The use of medications must be considered. 

Anticoagulants are a group of blood thinning medications used during hemodialysis to prevent blood clotting when blood is filtered through machines. Several different types of anticoalgulants may be used and many can rarely cause hair loss. The mechanism by which they cause hair loss is typically a telogen effluvium although other mechanisms may occur as well. 

Apsner and colleagues, in 2001, reported 5 hemodialysis patients who had hair loss from the low molecular weight heparin blood thinner dalteparin. All patients reported that their hair loss stopped when the dalteparin was stopped and a different method of anticoagulation (regional citrate anticoagulation) was used. 4 of the 5 patients even regained hair. In 2003, Sarris and colleagues reported a hemodialysis patient who had hair loss after switching from one low molecular weight heparin (enoxaparin) to tinzaparin. Hair regrowth resumed after switching back to enoxaparin. 

Conclusion

There are many potential reasons for hair loss in patients receiving hemodialysis. Careful review of all factors is needed. Anticoagulants used during hemodialysis, including the low molecular weight heparins, need to be considered. 

Reference

Sarris E, et al. Am J Kidney Dis. 2003.

Apsner R, et al. Blood. 2001