Do standard therapeutic doses of enoxaparin increase the risk of major bleeding in non-dialysis-dependent patients with severe renal insufficiency?
Standard therapeutic doses of enoxaparin in patients with severe renal insufficiency increase the risk of major bleeding, highlighting the potential need for empirical dose adjustment.
Non-dialysis-dependent patients with a creatinine clearance of 30 mL/min or less who are treated with standard therapeutic doses of enoxaparin have elevated levels of anti-Xa and an increased risk for major bleeding. Empirical dose adjustment of enoxaparin may reduce the risk for bleeding and merits additional evaluation. No conclusions can be made regarding other LMWHs.
Lim et al. (2006) studied this question.