Review of Dosing & Monitoring LMWH in Patients with Renal Insufficiency & Obesity

Henry I. Bussey, Pharm.D., FCCP, FAHA
August, 2009

Four ClotCare editorial board members recently published an authoritative review of dosing and monitoring considerations with low molecular weight heparin (LMWH) in patients with renal insufficiency and obesity.

This paper provides a thorough literature review and expert insight on three long-standing controversies:

1. Is dosage adjustment of low molecular weight heparin (LMWH) needed in obese patients?
2. How should LMWH dosage adjustment be implemented in patients with renal insufficiency?
3. When and how should one monitor the plasma concentrations of LMWH?

Nutescu EA, Spinler SA, Wittkowsky A, Dager WE. Low-molecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings. Ann Pharmacother. 2009 Jun;43(6):1064-83.