Low Molecular Weight Heparins and Glomerular Filtration Rate: A Report to be Considered

Fabio      Fabbian; Alfredo      De Giorgi; Marco      Pala; Ruana      Tiseo; Francesco      Portaluppi; Davide      Imberti; Roberto      Manfredini

Abstract

Venous thromboembolism is a common condition and low molecular weight heparins (LMWHs) are widely used for its treatment. Chronic kidney disease (CKD) is also a frequent disease especially in subjects with comorbidities admitted to internal medicine wards. LMWHs are eliminated by the kidney and their half-life is increased in renal impairment. Based on a series of available studies we analyzed the relationship between treatment with LMWHs and different degrees of renal impairment including end-stage renal disease (ESRD). In order to reduce haemorrhagic risk, the LMWH dose should be reduced in CKD, even if reducing LMWH dose could impair drug effectiveness. Further studies relating glomerular filtration rate to LMWH effectiveness and side effects are required.

Keywords: Low molecular heparin, chronic kidney disease, dialysis, glomerular filtration rate, thromboembolism, acute coronary syndrome, atrial fibrillation, ischaemic stroke, cardiomyopathy, plasminogen activator inhibitor type 1