Enoxaparin and Bleeding Complications: A Review in Patients with and without Renal Insufficiency

Abstract

Study Objective. To compare the frequency of bleeding complications from enoxaparin in patients with normal renal function versus patients with renal insufficiency. Design. Retrospective chart review. Setting. University‐based tertiary care center. Patients. One hundred six patients who received two or more doses of enoxaparin. Measurements and Main Results. Total bleeding complications occurred in 22% of patients with normal renal function and 51% with renal insufficiency (p<0.01). Major bleeds were also significantly different, 2% and 30%, respectively (p<0.001). No patients with normal renal function were given fresh‐frozen plasma or packed red blood cells, whereas in those with renal insufficiency, 13% and 32%, respectively, received these products (p<0.01). Conclusion. Enoxaparin may have resulted in increased bleeding complications and use of blood products in patients with renal insufficiency. Prospective studies need to be conducted to define the drug's role and dosage adjustments in these patients. (Pharmacotherapy 2000; 20(7):771–775)