title: Correlation of antifactor Xa concentrations with renal function in patients on enoxaparin.
abstract: Enoxaparin is a low molecular weight heparin (LMWH) that has been shown to be effective in deep vein thrombosis, pulmonary embolism, and unstable angina. Because renal function plays an important role in the clearance of LMWH, the authors sought to investigate the effect of renal function on enoxaparin. This prospective multiple-dose study evaluated 18 patients with varying degrees of renal function initiated on enoxaparin 1 mg/kg subcutaneously every 12 hours. Peak blood levels of anti-Xa concentrations were obtained 4 +/- 0.5 hours postdose after receiving at least three doses of enoxaparin. The median antifactor Xa levels were higher in patients with creatinine clearance (CLCr) < or = 30 mL/min compared to CLCr > or = 31 mL/min (1.34 IU/mL vs. 0.91 IU/mL, respectively, p < 0.05). A linear correlation was established between creatinine clearance and anti-Xa concentrations (p < 0.0005). On the basis of the data, the authors believe that a dose adjustment is necessary in patients receiving repeated doses of enoxaparin with CLCr < or = 30 mL/min.
authors.affiliation: University at Buffalo, State University of New York, Kaleida Health Systems, Buffalo, New York, USA.
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Chow
authors.forename: Kimberly
authors.initials: K
authors.lastname: Zammit
authors.forename: Kathleen
authors.initials: K
authors.lastname: West
authors.forename: MaryAnne
authors.initials: M
authors.lastname: Dannenhoffer
authors.forename: Angel
authors.initials: A
authors.lastname: Lopez-Candales
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D017984:Enoxaparin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015951:Factor Xa / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000145:classification / Q000150:complications / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D015951:Factor Xa