Enoxaparin vs. Heparin for Venous Thromboembolism Prophylaxis in Dialysis Patients

Because enoxaparin undergoes substantial renal clearance, lower doses are advised for patients with severe renal impairment; indeed, many clinicians avoid this drug altogether in patients with advanced kidney disease. In this retrospective study, researchers examined whether subcutaneous enoxaparin was associated with higher bleeding risk than standard heparin in hemodialysis and peritoneal dialysis patients who received prophylaxis against venous thromboembolism. The data source was a commercial dialysis services provider that covers about 30% of U.S. dialysis patients.

About 3000 patients received once-daily enoxaparin (50% received 30 mg, and the others received higher doses), and about 5000 received standard heparin (5000 units twice or …