skip to main content

Heparin Timing Dental Procedure Dialysis — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

EasyHaemodialysisHeparin Timing Dental Procedure DialysisESENeph

A 70-year-old man with CKD G5D on haemodialysis via a well-functioning AVF requires urgent dental extraction. He is heparinised during dialysis. His session is today (Monday) and the dental extraction is scheduled for Wednesday. What is the most appropriate haemodialysis anticoagulation strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Heparinise normally on Monday — no adjustment needed as extraction is 2 days away

With dental extraction scheduled for Wednesday and dialysis on Monday, standard heparinisation on Monday is appropriate. Standard unfractionated heparin has a half-life of approximately 1-2 hours and is fully cleared within 4-6 hours. By Wednesday (>48 hours later), there is no residual anticoagulant effect. Heparin-free dialysis or citrate anticoagulation would only be necessary if the procedure were planned within 4-12 hours of the dialysis session (e.g., same day or next morning). For procedures within 12 hours of dialysis, heparin-free dialysis or regional citrate should be used. This question tests understanding of heparin pharmacokinetics in dialysis patients.

Reference: UKKA 2019 – Haemodialysis Guidelines; BSH 2011 – Perioperative Anticoagulation Management