PMID- 34732929
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221202
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 56
IP  - 6
DP  - 2021 Dec
TI  - Evaluation of Enoxaparin for Inpatient Venous Thromboembolism Prophylaxis in 
      End-Stage Renal Disease Patients on Hemodialysis.
PG  - 718-724
LID - 10.1177/0018578720954151 [doi]
AB  - Background: Enoxaparin is not recommended for venous thromboembolism (VTE) 
      prophylaxis in the end-stage renal disease (ESRD) on hemodialysis (HD) population 
      due to concerns for drug accumulation and increased bleeding risk. Due to the 
      paucity of literature with clinical outcomes to support this theoretical safety 
      concern, the purpose of this study was to compare the risks of bleeding of 
      enoxaparin and unfractionated heparin (UFH) in hospitalized, HD-dependent 
      patients. Methods: This retrospective cohort study examined ESRD on HD patients 
      who received either subcutaneous enoxaparin or UFH for VTE prophylaxis and were 
      admitted for at least 48 hours. The primary outcome was major bleeding or 
      clinically relevant non-major bleeding (CRNMB) as guided by definitions from the 
      International Society of Thrombosis and Haemostasis. Results: A total of 322 
      enoxaparin and 10 UFH patients were analyzed. All enoxaparin patients were dosed 
      30 mg subcutaneous daily. Twenty-two (6.8%) enoxaparin and zero UFH patients 
      experienced major or CRNMB (P = .498). Three enoxaparin patients suffered fatal 
      hemorrhages. Multiple logistic regression demonstrated thrombocytopenia was 
      associated with bleeding (odds ratio 4.23, P = .004). Conclusion: The difference 
      in major or CRNMB rates between both anticoagulants was not statistically 
      significant. However, the 6.8% bleed rate is concerning for inpatient enoxaparin 
      usage, and caution should be applied when considering this drug for VTE 
      prophylaxis in the ESRD on HD population.
CI  - (c) The Author(s) 2020.
FAU - Sacks, Jamie
AU  - Sacks J
AD  - Broward Health Medical Center, Fort Lauderdale, FL, USA.
AD  - Cooper University Hospital, Camden, NJ, USA.
FAU - Luc, Stanley A
AU  - Luc SA
AUID- ORCID: 0000-0002-1294-7985
AD  - Broward Health Medical Center, Fort Lauderdale, FL, USA.
LA  - eng
PT  - Journal Article
DEP - 20200904
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC8559058
OTO - NOTNLM
OT  - anticoagulants
OT  - medication safety
OT  - nephrology
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/11/05 06:00
MHDA- 2021/11/05 06:01
PMCR- 2022/12/01
CRDT- 2021/11/04 06:18
PHST- 2021/11/04 06:18 [entrez]
PHST- 2021/11/05 06:00 [pubmed]
PHST- 2021/11/05 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - 10.1177_0018578720954151 [pii]
AID - 10.1177/0018578720954151 [doi]
PST - ppublish
SO  - Hosp Pharm. 2021 Dec;56(6):718-724. doi: 10.1177/0018578720954151. Epub 2020 Sep 
      4.