Table 1

Use of anticoagulants for the treatment of venous thromboembolism in patients with renal insufficiency.

Anticoagulant	Recommendation^a)
Unfractionated heparin	CrCl ≥30 mL/min: no adjustment
Unfractionated heparin	CrCl <30 mL/min: no adjustment, use with caution
LMWH	CrCl ≥30–80 mL/min: no adjustment, use with caution
LMWH	CrCl <30 mL/min: enoxaparin - 1 mg/kg subcutaneously once a day, use with caution, anti-Xa monitoring is recommended if applicable; dalteparin - dose adjustment according to anti-Xa activity, use with caution
Warfarin	No adjustment recommended
Edoxaban	CrCl ≥50 mL/min: no adjustment
	CrCl 15–49 mL/min: 30 mg once daily
	CrCl <15 mL/min: not recommended
Dabigatran	CrCl ≥50 mL/min: no adjustment
	CrCl 30–49 mL/min: 110 mg twice daily
	CrCl <30 mL/min: not recommended
Rivaroxaban/Apixaban	CrCl ≥30 mL/min: no adjustment
	CrCl 15–29 mL/min: no adjustment, use with caution
	CrCl <15 mL/min: not recommended

^a)Detailed recommendations may differ slightly according to guidelines and in the context of clinical trials. The list above is based on the approval package of each drug from the Korean Food and Drug Safety (KFDS) for the treatment of venous thromboembolism.

Abbreviations: CrCl, creatinine clearance; LMWH, low-molecular-weight heparin.

Blood Res 2021;56:6~16 https://doi.org/10.5045/br.2021.2020083