[Bleeding complication due to accumulation of low-molecular-weight heparin in a patient with renal insufficiency].
We report of a 71-year-old woman with a history of chronic analgesic nephropathy, who underwent coronary angiography. Because of anterior ventricular aneurysm, anticoagulation with nadroparine was installed. Continued ACE-inhibitor and ASA with additional intravenous contrast substance lead to acute tubular necrosis with rapid decline of the renal function. Due to accumulation of the low molecular weight heparin, the patient developed an extensive retroperitoneal haematoma with circulatory shock and temporary anuric kidney failure. Low molecular weight heparins are commonly used during percutaneous coronary interventions. They are as safe and efficient compared to unfractioned heparin. But due to their renal elimination, they have to be monitored by measuring anti-factor Xa-activity if creatinine-clearance is <30 ml/min.
Schneiter
S
S
Abteilung für Nephrologie, Kantonsppital Aarau.
Huynh-Do
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U
Heizmann
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M
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000628:therapy / Q000652:urine; D000293:Adolescent; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001002:Anuria / Q000139:chemically induced; D002648:Child; D003404:Creatinine / Q000097:blood / Q000652:urine; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D005260:Female; D005919:Glomerular Filtration Rate; D006406:Hematoma / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D015201:Meta-Analysis as Topic; D008991:Monitoring, Physiologic; D017762:Nadroparin / Q000008:administration & dosage / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications* / Q000652:urine; D012187:Retroperitoneal Space; D012307:Risk Factors; D012769:Shock / Q000139:chemically induced; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D017762:Nadroparin; D003404:Creatinine