Introduction: Hemodialysis is the most widely used method of replacement therapy for end-stage renal failure. It is a process of blood purification using extracorporeal blood circulation, and the exchange of substances between blood and dialysis solution takes place in the dialyzer. The most important part of the dialyzer is the membrane, which is a selectively permeable microporous foil, usually made of a natural or synthetic polymer. During hemodialysis, the patient's blood comes into contact with an artificial surface. The contact of blood with the artificial surface causes the activation of the coagulation system and platelets and consequently blood clotting. Purpose: The purpose of the diploma thesis is to determine what anticoagulant heparin therapy is in dialysis patients, what are the possible complications of treatment and the tasks of a nurse in anticoagulation during hemodialysis. Methods: We used a descriptive method of work. With a review of domestic and foreign professional and scientific literature. We searched the literature in the following databases: MedLine, Science Direct, CINAHL, COBIB, Google Scholar and Pubmed search engine in the time period from June 2024 to December 2024. Using the keywords: hemodialysis, healthcare in hemodialysis, heparin and anticoagulation. Results: Anticoagulation is very important in dialysis patients, as it enables the successful implementation of the entire hemodialysis. Research and most studies have shown that the activation of the coagulation cascade is more intense when using cellulose membranes than when using synthetic ones. A similar finding was also shown for platelet activation. In addition to the membrane, other factors of the dialysis procedure affect more intense blood clotting in the dialysis system, such as: small blood circulation, high hematocrit, large ultrafiltrations, recirculation in the vascular access, transfusions and infusion of blood products during hemodialysis, lipid infusion, use of air traps. Therefore, the role of the nurse is also important for successful hemodialysis in patients. Discussion and conclusion: Standard heparin has been the mainstay of hemodialysis anticoagulation for decades. In hemodialysis, it is slowly being replaced by low molecular weight heparins, which are also recommended as the primary anticoagulant by the European hemodialysis guidelines. In patients at risk of bleeding, regional anticoagulation with citrate is the best alternative to heparin.
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