Management of Anticoagulation Therapy in Patients With Thromboembolism in the Context of Renal Dysfunction Academic Article uri icon

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  • BACKGROUND: Low-molecular-weight heparin is cleared through the kidneys and is commonly used for anticoagulation in the pediatric population. OBSERVATION: We present 3 challenging cases of children requiring anticoagulation in the context of acute kidney injury, nephrotic syndrome, and hemodialysis. CONCLUSIONS: A significant change in anti-factor Xa (anti-Xa) levels-used for drug monitoring-should prompt an assessment of renal function. In nephrotic syndrome, anti-Xa levels should be closely monitored when there is a change in the status of nephrotic disease activity. In hemodialysis patients, enoxaparin at once daily reduced dosing should be considered with trough and peak anti-Xa levels monitoring.


  • Bahabri, Aban
  • Chan, Anthony KC
  • Belostosky, Vladimir
  • Bhatt, Mihir

publication date

  • December 23, 2020