A systematic review on the accumulation of prophylactic dosages of low-molecular-weight heparins (LMWHs) in patients with renal insufficiency
| العنوان: | A systematic review on the accumulation of prophylactic dosages of low-molecular-weight heparins (LMWHs) in patients with renal insufficiency |
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| المؤلفون: | Jorie Versmissen, Frank W.G. Leebeek, Teun van Gelder, Ferdows Atiq, Patricia M. L. A. van den Bemt |
| المساهمون: | Pharmacy, Hematology, Internal Medicine |
| المصدر: | European Journal of Clinical Pharmacology European Journal of Clinical Pharmacology, 71(8), 921-929. Springer-Verlag |
| بيانات النشر: | Springer Berlin Heidelberg, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | medicine.medical_specialty, Dose, Review Article, Pharmacology, Gastroenterology, Clinical trials, Internal medicine, Heparins, medicine, Humans, In patient, Pharmacology (medical), Renal Insufficiency, Venous Thrombosis, business.industry, Anticoagulants, General Medicine, Heparin, Heparin, Low-Molecular-Weight, medicine.disease, Clinical trial, Venous thrombosis, Pharmacodynamics, Meta-analysis, Dose reduction, business, medicine.drug |
| الوصف: | 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. Methods A 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. Results For 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. Conclusions In 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. Electronic supplementary material The online version of this article (doi:10.1007/s00228-015-1880-5) contains supplementary material, which is available to authorized users. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1432-1041 0031-6970 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8da38844ac051a8242069d0676bc1cd5Test http://europepmc.org/articles/PMC4500846Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8da38844ac051a8242069d0676bc1cd5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321041 00316970 |
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