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Use of Low Molecular Weight Heparins and Glycoprotein IIb/IIIa Inhibitors in Patients with Chronic Kidney Disease
Author(s) -
Perazella Mark A.,
Mosenkis Ari,
Berns Jeffrey S.
Publication year - 2004
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.0894-0959.2004.17351.x
Subject(s) - medicine , dosing , kidney disease , renal function , pharmacokinetics , clinical trial , low molecular weight heparin , heparin , intensive care medicine , acute coronary syndrome , pharmacology , myocardial infarction
Despite aggressive intervention, cardiac causes of death, including acute coronary syndrome (ACS), continue to be a major source of mortality in patients with chronic kidney disease (CKD), including end‐stage renal disease (ESRD). Multiple large prospective trials have demonstrated the clinical benefits of both low molecular weight heparin (LMWH) and glycoprotein (Gp) IIb/IIIa inhibitors in treating patients with ACS. Unfortunately patients with significant impairment of kidney function have generally been excluded from these major clinical trials. Consequently relatively little is known about the pharmacokinetics, appropriate dosing, efficacy, and safety of these medications in patients with CKD of various stages. This article examines the available literature regarding the pharmacokinetics, dosing, efficacy, and safety of LMWH and Gp IIb/IIIa inhibitors in patients with CKD.