May 2, 2006
View Full PaperMeta-Analysis: Low-Molecular-Weight Heparin and Bleeding in Patients with Severe Renal Insufficiency
Structured PICO
Do standard therapeutic doses of enoxaparin increase the risk of major bleeding in non-dialysis-dependent patients with severe renal insufficiency?
P
Population
Non-dialysis-dependent patients with severe renal insufficiency (creatinine clearance of 30 mL/min or less)
I
Intervention
Standard therapeutic doses of enoxaparin
O
Outcome
Major bleeding and elevated levels of anti-Xasafety
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.
Abstract
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.