https://www.ajkd.org/article/S0272-6386(02)00156-7/pdf

Pharmacokinetic studies of dalteparin (Fragmin), enoxaparin (Clexane), and danaparoid sodium (Orgaran) in stable chronic hemodialysis patients

https://www.ajkd.org/article/S0272-6386(12)00660-9/pdf

Use and Safety of Unfractionated Heparin for Anticoagulation During Maintenance Hemodialysis

Nadroparin calcium is a low molecular weight heparin with a mean molecular weight of 4.5 kD. Compared with unfractionated heparin, nadroparin calcium has a greater ratio of anti-factor Xa/anti-factor IIa activity. Nadroparin calcium has a longer half-life and greater bioavailability than unfractionated heparin and can be administered by subcutaneous injection once daily for prophylaxis and twice daily for treatment. In clinical trials, nadroparin calcium has been shown to be at least as effective as unfractionated heparin in preventing deep venous thrombosis (DVT) after various surgical procedures including major orthopaedic and abdominal surgery, and in maintaining the patency of the extracorporeal circulation in adults and children undergoing haemodialysis. Nadroparin calcium is well tolerated, the most common adverse event associated with its use being the development of minor haematoma at the operative incision site. In postmarketing surveillance data to date, the incidence of major haemorrhage related to nadroparin calcium use has been very low (< 1%). Nadroparin calcium has also been associated with a very low incidence of thrombocytopenia (< 0.001%). Thus, nadroparin calcium is an effective alternative to unfractionated heparin in the prophylaxis or treatment of thromboembolic venous events, with the advantages of more convenient administration and a lower incidence of thrombocytopenia.

Nadroparin calcium. A review of its pharmacology and clinical applications in the prevention and treatment of thromboembolic disorders.

Purpose
Although 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.

/pdf/a-systematic-review-on-the-accumulation-of-prophylactic-1dnkluqo76.pdf

A systematic review on the accumulation of prophylactic dosages of low-molecular-weight heparins (LMWHs) in patients with renal insufficiency

Citrate compared to low molecular weight heparin anticoagulation in chronic hemodialysis patients

The efficacy and safety of a low molecular weight heparin (LMWH) given as a single predialysis bolus injection was compared to standard heparin (SH) administered with a continuous infusion in a randomized, 6 month, open follow-up study in 70 patients undergoing hemodialysis No major bleeding or adverse events were encountered during a total of 4,000 dialysis procedures (2,000 with LMWH) Clot formation in the extracorporeal circuit was minimal and comparable between the groups at 4, 13, and 26 weeks after the start of the study No accumulation of LMWH anticoagulant activity was noted It is concluded that the use of LMWH is a safe, effective, and less complex alternative to SH

Long-term efficacy and safety of a low molecular weight heparin in chronic hemodialysis patients. A comparison with standard heparin.

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Long-term efficacy and safety of a low molecular weight heparin in chronic hemodialysis patients. A comparison with standard heparin.