title: Peak antifactor xa activity produced by dalteparin treatment in patients with renal impairment compared with controls.
abstract: OBJECTIVE
  To evaluate the relationship between impaired renal function and antifactor Xa activity in patients receiving dalteparin.
  
  
  METHODS
  Open-label prospective study.
  
  
  METHODS
  Inpatient and outpatient units of a large teaching hospital.
  
  
  METHODS
  Eleven patients with renal impairment and 11 control subjects with normal renal function.
  
  
  METHODS
  Subjects were administered dalteparin at a dosage of approximately 100 U/kg subcutaneously every 12 hours.
  
  
  RESULTS
  Peak steady-state antifactor Xa levels were compared between the groups. Mean +/- SD levels were similar for patients with and without renal impairment: 0.47 +/- 0.25 and 0.55 +/- 0.20 U/ml, respectively. A test of equivalency showed statistical significance (p=0.0001).
  
  
  CONCLUSIONS
  No meaningful difference in peak antifactor Xa activity was found between patients with renal impairment and control subjects. To the extent that peak antifactor Xa levels can be used as markers for adjusting doses of dalteparin, these data suggest that such adjustments are not necessary for patients with renal impairment who are not receiving dialysis.
authors.affiliation: Department of Pharmacy, Montefiore Medical Center, Bronx, New York, USA. adamshprecher@yahoo.com
authors.forename: Adam R
authors.initials: AR
authors.lastname: Shprecher
authors.forename: Angela
authors.initials: A
authors.lastname: Cheng-Lai
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Madsen
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sinnett
authors.forename: Serena T
authors.initials: ST
authors.lastname: Wong
authors.forename: Henny H
authors.initials: HH
authors.lastname: Billett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D016022:Case-Control Studies; D017985:Dalteparin / Q000627:therapeutic use*; D015951:Factor Xa / Q000378:metabolism*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D000925:Anticoagulants; D015951:Factor Xa; D017985:Dalteparin