SynthesisEuropean journal of clinical pharmacology2012
Increased major bleeding risk in patients with kidney dysfunction receiving enoxaparin: a meta-analysis.
Synthesis in European journal of clinical pharmacology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Systematic review of interventions to improve safety and quality of anticoagulant prescribing for therapeutic indications for hospital inpatients.European journal of clinical pharmacology · 2019Pooled it
- Safety of low-molecular-weight heparin compared to unfractionated heparin in hemodialysis: a systematic review and meta-analysis.BMC nephrology · 2017Pooled it
- [Anticoagulation in critical care].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Enhancing therapeutic strategies and drug development for patients with kidney disease.Expert opinion on drug safety · 2026Review
- Tinzaparin-a review of its molecular profile, pharmacology, special properties, and clinical uses.European journal of clinical pharmacology · 2022Review
- Approach to Thromboprophylaxis for Prevention of Venous Thromboembolism in COVID-19: Global Updates and Clinical Insights from India.Clinics and practice · 2022Review
- Correct use of non-indexed eGFR for drug dosing and renal drug-related problems at hospital admission.European journal of clinical pharmacology · 2020Observational
- Tinzaparin Sodium Pharmacokinetics in Patients with Chronic Kidney Disease: Practical Implications.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2020Review
- Direct oral anticoagulants in patients with chronic kidney disease: patient selection and special considerations.International journal of nephrology and renovascular disease · 2017Review
- Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 2: treatment.Current oncology (Toronto, Ont.) · 2015Article
- Clinical challenges in patients with cancer-associated thrombosis: Canadian expert consensus recommendations.Current oncology (Toronto, Ont.) · 2015Article
- Is extended pharmacologic venous thromboembolism prophylaxis uniformly safe after radical cystectomy?Urology · 2014Article
- [Low molecular weight heparin in patients with impaired renal function].Der Internist · 2012Article
- Prevalence of potentially inappropriate medication and its correlates in elderly hospitalized patients: A cross-sectional study based on Beers criteria.Journal of family & community medicineArticle
- Heparin-Induced Thrombocytopenia in Chronic Hemodialysis Patients.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe elimination half-life and consequently the accumulation of enoxaparin increase as glomerular filtration rate (GFR) decreases. A dose adjustment for patients with a GFR <30 ml/min is recommended and considered relatively safe. Our intention was to identify whether the use of enoxaparin is safe and to determine what impact an enoxaparin dose adjustment has on patients with a GFR <60 ml/min.
methodsA PubMed search and meta-analysis of literature were performed. Studies were analyzed to compare enoxaparin versus other heparins/heparinoids and investigate enoxaparin at different stages of kidney dysfunction. Only controlled trials were considered, and the enoxaparin dose had to be specified. The clinical endpoint was defined as apparent major bleeding.
resultsOut of 1,027 publications, 20 studies met the criteria and were analyzed. Our meta-analysis shows that enoxaparin major bleeding complications at a GFR < 60 ml/min increase significantly, with a relative risk (RR) of 1.67 [95% confidence interval (CI) 1.12-2.50) compared with other anticoagulants (p = 0.01). RR for patients on enoxaparin therapy increases exponentially with each stage of chronic kidney disease (CKD stage 1-5) [RR = 0.585 x exp(0.524 x CKD)]. Despite dose adjustment, the major bleeding risk is still significantly increased in patients with a GFR < 60 ml/min versus those with a GFR > 60 ml/min.
conclusionOnly patients with a GFR > 60 ml/min can be safely treated with enoxaparin.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.