Antithrombotic Prophylaxis and Therapy in Renal Failure

The authors postulate a “deep compartment” for enoxaparin. This is surprising in view of a distribution volume of some 5 liters and monophasic elimination (compare product information). Because of the structural differences of low molecular weight heparins, the pharmacokinetics of each low molecular weight heparin should be examined individually (1). Such substance specific studies in renal failure have been published for enoxaparin for a long time and have resulted in different dosage recommendations (1, 2, product information). Unfortunately, all this was ignored in the review article. For this reason, the article’s conclusions directly contradict the national and international licensing status of enoxaparin (for example, the US Food and Drug Administration [FDA]’s or the German Federal Institute for Drugs and Medical Devices [BfArM]’s). After repeated subcutaneous administration of the prophylactic dose (40 mg) in patients with a creatinine clearance