Huang SHS, Qi K, Louzada M, et al. - Among 10 quotidian (7 in-center and 3 home) and 8 nocturnal home hemodialysis (HD) patients, researchers investigated the optimal dose, treatment effectiveness, and patient safety of dalteparin. In these patients, dalteparin was started and titrated depending on the clotting score. Measurement of trough anti-Xa levels was obtained. Following 4 weeks, the median dalteparin dose was 1875 units [1250, 2500] for 10 quotidian HD patients. Switching back to heparin because of high clotting scores while receiving dalteparin within 4 weeks was reported in five of the eight nocturnal HD patients. However, at 4 weeks, three patients continued on dalteparin. The effective use and relative safety of dalteparin in quotidian HD were suggested in this small pilot study. However, successful use of it was reported in a small proportion of nocturnal HD patients. Experts recommended evaluating alternative methods, including second dalteparin bolus following 4 hours of HD treatment, for efficacy and practicality.