Concomitant use of argatroban and warfarin during hemodialysis in heparin-induced thrombocytopenia

Objective and importance: The use of argatroban during hemodialysis in a patient receiving warfarin is not established. We present a case of heparin-induced thrombocytopenia in a patient on hemodialytic therapy who successfully received argatroban concomitantly to warfarin during renal replacement therapy. Clinical presentation: A 46-year-old male patient with autosomal dominant polycystic kidney disease presented with heparin-induced thrombocytopenia (HIT) arised during dialytic procedures. Intervention: After the acute episode requiring argatroban and warfarin therapy, the patient continued to receive argatroban during the hemodialytic session concomitantly to warfarin. Conclusion: The administration of argatroban in the dialytic circuit of a patient on oral anticoagulant therapy can be considered an effective and safe approach.