My father age 72 at the time, fell and broke his knee. He is on Coumadin due to a DVT in 2002, in which Lovenox led to compartment syndrome and faciotomy. He was given Lovenox and had retroperitoneal bleed, paralyzed his right leg. GFR was 30 at the highest, more in the teens and 20’s. He has a baseline creatinine of 2.4, and is borderline being sent for dialysis. What are the recommendations for Lovenox and kidney failure….stage 3, solitary kidney?

The dose of Lovenox (enoxaparin) must be reduced in patients with chronic kidney disease (CKD).  I have observed a greater risk of bleeding in patients with CKD when using anti-coagulants of all kinds including Lovenox.  This risk is greater than in the general population that does not have CKD.  It is necessary to weigh the risks and the benefits of blood thinning (anti-coagulants) in all patients, but especially in patients with CKD.  I counsel my patients of the increased risk and then discuss recommendations for each individual patient as to what benefits they might see and also the risks.  I suggest that you have this discussion with your father’s doctors.

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