Abstract
Background: In most clinical settings, low-molecular-weight heparins (LMWH) are preferred over unfractionated heparin (UHF). However, the use of LMHW in patients with renal insufficiency is limited because they tend to accumulate. Methods: The literature is reviewed regarding pharmacologic properties of different LMWHs and their use in patients with renal insufficiency. Results: The risk of accumulation is dependent on the molecular weight: smaller LMHW have a higher risk of accumulation. Therefore, a LMHW with high molecular weight should be chosen. The patient's individual renal function, bleeding risk and the chance of upcoming interventions need to be assessed. When LMWH are used in patients with renal insufficiency, peak Anti-Xa levels must be monitored closely. Conclusions: LMWH can be used in patients with severe renal insufficiency if a close monitoring of the patient and the therapeutic effect is possible.
Published Version
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