Is Enoxaparin Safe for Patients with Renal Failure?

Unlike unfractionated heparin (UFH), the low-molecular-weight heparin enoxaparin (Lovenox) is excreted mainly by the kidneys. To determine whether this characteristic heightens bleeding risk in patients with renal insufficiency, researchers in Connecticut compared bleeding rates with enoxaparin and UFH in a retrospective study of 620 hospitalized patients with renal insufficiency.

All patients received full therapeutic doses of enoxaparin or UFH. Renal insufficiency was mild (glomerular filtration rate, 41-60 mL/minute) in 50%, moderate (21-40 mL/minute) in 34%, and severe (≤20 mL/minute) in 16%. In analyses that were adjusted for potential confounders, rates of major bleeding did not differ significantly between enoxaparin and UFH recipient…