Enoxaparin versus unfractioned heparin as anticoagulant for continuous venovenous hemodialysis: a randomized open-label trial

Figures & data

TABLE 1.  Baseline clinical characteristics and coagulation parameters of the patient population

	UFH (n = 21)	LMWH (n = 19)	p
Age (years)^a	54.2 ± 19^a	60.5 ± 14	0.26
Males, n (%)	8 (38)	7 (37)	1.00
Ischemic/multifactorial ARF^b (%)	29/71	42/58	0.51
Blood urea nitrogen (mg/dL)	72 ± 32	65 ± 34	0.49
Serum creatinine (mg/dL)	3.2 ± 1.6	3.1 ± 1.1	0.87
Platelets (10^3/μL)	279 ± 121	267 ± 131	0.77
PT (%)	64.2 ± 14.9	65.1 ± 23	0.89
aPTT (seconds)	54.4 ± 44.0	44.0 ± 12.8	0.06
Use of anti-platelet aggregation drugs, n (%)	3 (14.3)	1 (5.3)	0.63
Use of vasopressors, n (%)	16 (78)	14 (75)	0.85
Presence of sepsis (%)	85.7	94.7	0.60
APACHE II at ICU entry	24.4 ± 7.0	22.1 ± 8.4	0.33

Notes: UFH, unfractioned heparin; LMWH, low-molecular weight heparin; PT, prothrombin time; aPTT, activated partial thromboplastin time; CRRT, continuous renal replacement therapy.

^aMean ± SD.

^bCause of acute renal failure: ischemic or multifactorial.

TABLE 2.  Coagulation parameters during CVVHD in enoxaparin and UFH groups

	24 hours			48 hours
	LMWH (n = 19)	UFH (n = 21)	p	LMWH (n = 10)	UFH (n = 11)	p
Platelets (10^3/μL)	178 ± 83^a	199 ± 124	0.51	204 ± 91	156 ± 85	0.21
PT (%)	63.8 ± 18.0	57.5 ± 11.7	0.31	77.3 ± 11.3	56.1 ± 20.0	0.014
aPTT (seconds)	62.4 ± 28.6	89.1 ± 50.4	0.06	59.5 ± 29.1	74.0 ± 30.5	0.29
Fibrinogen (mg/dL)	477 ± 200	479 ± 193	0.97	521 ± 180	490 ± 156	0.66
D-dimers^b	1.19 ± 0.6	2.13 ± 1.1	0.89	2.12 ± 1.1	3.07 ± 1.79	0.39
Anti-factor Xa^c (IU/mL)	0.62 (0.28–1.00)^d	0.13 (0.04–0.38)	<0.001	1.15 (0.87–1.54)	0.12 (0.02–0.31)	0.001

Notes: UFH, unfractioned heparin; LMWH, low-molecular-weight heparin; PT, prothrombin time; aPTT, activated partial thromboplastin time.

^aMean ± SD.

^bD-dimers: <5 μg/dL.

^cTherapeutic reference values according to manufacturer – UFH: 0.15–0.30 IU/mL and LMWH: 0.5–1.2 IU/mL.¹⁷

^dMedian and interquartile range.

TABLE 3.  Clinical and laboratory variables in patients with or without bleeding anticoagulated with enoxaparin in CVVHD

	24 hours			48 hours
	With bleeding (n = 3)	Without bleeding (n = 16)	p	With bleeding (n = 2)	Without bleeding (n = 8)	p
Age (years)^a	46.4 ± 14.1	65 ± 11.7	0.008	52.0 ± 15.4	59.9 ± 19.7	0.60
APACHE II^b	23.4 ± 6.3	23.2 ± 8.0	0.95	23.7 ± 6.1	22.6 ± 9.6	0.68
Platelets (10^3/μL)	127 ± 56	196 ± 84	0.11	107 ± 53	229 ± 84	0.09
aTTP (seconds)	57.4 ± 16.2	63.9 ± 13	0.70	66 ± 33	57.4 ± 30	0.74
PT (%)	63.2 ± 29.0	63.9 ± 31.8	0.94	96.5 ± 44.9	72.5 ± 36.7	0.002
Anti-factor Xa^c (IU/mL)	0.60 (0.35–1.64)	0.62 (0.18–1.02)	0.72	1.62 (1.54–1.69)	1.13 (0.52–1.23)	0.09
LMWH dose (mg/kg/dose)	0.73 ± 0.18	0.62 ± 0.11	0.15	0.76 ± 0.15	0.66 ± 0.13	0.21

Notes: LMWH, low-molecular-weight heparin; PT, prothrombin time; aTTP, activated partial thromboplastin time.

^aMean ± SD.

^bMeasured at ICU entry.

^cMedian and interquartile range.

Miller R, Kingswood C, Bullen C, Cohen S. Renal replacement therapy in the ICU: The role of continuous arteriovenous hemodialysis. Br J Hosp Med. 1990;43:354–362.

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