Prevention of Deep Venous Thrombosis in Patients with Renal Failure

Low-molecular-weight heparins (LMWHs) are safe and effective for preventing deep venous thrombosis (DVT) in a variety of settings (JW Oncol Hematol Jul 1 2008 and JW Oncol Hematol Sep 9 2008). However, concerns have been raised about administering LMWHs to patients with moderate-to-severe renal impairment because these agents might result in excessive anticoagulation and bleeding as a result of bioaccumulation.

To investigate this issue, the Canadian Critical Care Trials Group conducted an industry-supported, multicenter, single-arm investigation of dalteparin (Fragmin) involving 138 critically ill patients with severe renal insufficiency (baseline mean creatinine clearance, 18.9 mL/minute; 61.6% of patients had acute renal failure; 8.7% wer…