Low-molecular-weight heparin in patients with chronic renal insufficiency

Low-molecular-weight heparin (LMWH) has largely replaced unfractionated heparin for the treatment of venous thromboembolism. The predictable anticoagulant effect of LMWH is seen across almost all patient populations, with few exceptions. However, because LMWH is primarily eliminated through the kidneys, patients with renal insufficiency are at risk of LMWH accumulation and bleeding complications. The risk of LMWH accumulation and bleeding is …