SynthesisEuropean journal of clinical pharmacology2015
A systematic review on the accumulation of prophylactic dosages of low-molecular-weight heparins (LMWHs) in patients with renal insufficiency.
Synthesis in European journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02719418 (Study of the Bioaccumulation of Tinzaparin in Renally Impaired Patients When Given at Prophylactic Doses), which is not on this map. Cited by 29 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.
Study of the Bioaccumulation of Tinzaparin in Renally Impaired Patients When Given at Prophylactic Doses
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- A systematic review of the efficacy and safety of anticoagulants in advanced chronic kidney disease.Journal of nephrology · 2022Pooled it
- Tinzaparin Safety in Patients With Cancer and Renal Impairment: A Systematic Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Renal function and clinical outcome of patients with cancer-associated venous thromboembolism randomized to receive apixaban or dalteparin. Results from the Caravaggio trialHaematologica · 2022Trial
- Evaluation of prophylactic dosages of Enoxaparin in non-surgical elderly patients with renal impairment.BMC pharmacology & toxicology · 2019Trial
- Preferences Among Expert Physicians in Areas of Uncertainty in Venous Thromboembolism Management: Results from a Multiple-Choice Questionnaire.Journal of clinical medicine · 2025Article
- Being precise with anticoagulation to reduce adverse drug reactions: are we there yet?The pharmacogenomics journal · 2024Review
- UK prescribing practice of anticoagulants in patients with chronic kidney disease: a nephrology and haematology-based survey.BMC nephrology · 2023Article
- Trough anti-Xa activity after intermediate dose nadroparin for thrombosis prophylaxis in critically ill patients with COVID-19 and acute kidney injury.Scientific reports · 2022Article
- [Expert consensus on the prevention and treatment of multiple myeloma related venous thromboembolism in China (2022)].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2022Article
- Haemorrhagic complications in patients with renal insufficiency during treatment or prophylaxis with dalteparin.European journal of hospital pharmacy : science and practice · 2022Article
- [Coagulation diagnostics in the clinical routine-part 2 : Monitoring of anticoagulation treatment, new-onset thrombocytopenia and thrombophilia].Innere Medizin (Heidelberg, Germany) · 2022Article
- Effects of dalteparin on anti-Xa activities cannot be predicted in critically ill COVID-19 patients.British journal of clinical pharmacology · 2022Article
- Prophylaxis of cancer-associated venous thromboembolism with low-molecular-weight heparin-tinzaparin: Real world evidence.Oncology letters · 2022Article
- Incidence, risk factors, and management of bleeding in patients receiving anticoagulants for the treatment of cancer-associated thrombosis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Review
- Reversal Activity and Toxicity of Heparin-Binding Copolymer after Subcutaneous Administration of Enoxaparin in Mice.International journal of molecular sciences · 2021Article
- Heparin beyond anti-coagulation.Current research in translational medicine · 2021Review
- Monitoring of Enoxaparin during Hemodialysis Covered by Regional Citrate Anticoagulation in Acute Kidney Injury: A Prospective Cohort Study.Journal of clinical medicine · 2021Article
- Optimization of Heparin Monitoring with Anti-FXa Assays and the Impact of Dextran Sulfate for Measuring All Drug Activity.Biomedicines · 2021Article
- Heparins have adequate ex vivo anticoagulant effects in hospitalized patients with cirrhosis.Journal of thrombosis and haemostasis : JTH · 2021Article
- A Distinctive Approach to Venous Thromboembolism Treatment in a Pediatric, Hemodialysis Patient: A Case Report.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough therapeutic dosages of most low-molecular-weight heparins (LMWHs) are known to accumulate in patients with renal insufficiency, for the lower prophylactic dosages this has not been clearly proven. Nevertheless, dose reduction is often recommended. We conducted a systematic review to investigate whether prophylactic dosages of LMWH accumulate in renal insufficient patients.
methodsA comprehensive search was conducted on 17 February 2015 using Embase, Medline, Web of Science, Scopus, Cochrane, PubMed publisher, and Google scholar. The syntax emphasized for LMWHs, impaired renal function, and pharmacokinetics. The search yielded 674 publications. After exclusion by reading the titles, abstracts, and if necessary the full paper, 11 publications remained.
resultsFor dalteparin and tinzaparin, no accumulation was observed. Enoxaparin, on the other hand, did lead to accumulation in patients with renal insufficiency, although not in patients undergoing renal replacement therapy. Bemiparin and certoparin also did show accumulation. No data were available for nadroparin.
conclusionsIn this systematic review, we show that prophylactic dosages of tinzaparin and dalteparin are likely to be safe in patients with renal insufficiency and do not need dose reduction based on the absence of accumulation. However, prophylactic dosages of enoxaparin, bemiparin, and certoparin did show accumulation in patients with a creatinine clearance (CrCl) below 30 ml/min, and therefore, dose reduction is required. The differences in occurrence of accumulation seem to depend on the mean molecular weight of LMWHs.
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Registered trials
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