Table 1.
Weight, kg | No renal impairment; eGFR ≥30 mL/min | Renal impairment; eGFR 15-30 mL/min | End-stage renal impairment; eGFR <15 mL/min or dialysis dependent |
---|---|---|---|
<50 | Enoxaparin: 20 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U bd |
50-100 | Enoxaparin: 40 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U bd |
101-150 | Enoxaparin: 40 mg bd or 80 mg daily | Enoxaparin: 20 mg daily | Unfractionated heparin: 5000 U tds |
>150 | Enoxaparin: 60 mg bd or 120 mg daily | Contact hematology for advice | Unfractionated heparin: 5000 U tds |
bd, twice daily; eGFR, estimated glomerular filtration rate; tds, 3 times daily.