Koury Jason, Schnakenberg Cintia, Villasenor Charlotte, Abraham Shirley
J Pediatr Pharmacol Ther. 2021;26(1):104-106. doi: 10.5863/1551-6776-26.1.104. Epub 2021 Jan 4.
Enoxaparin is a low molecular weight heparin (LMWH) that is the mainstay for treatment of pediatric patients with a venous thromboembolism, which provides better compliance compared with the use of unfractionated heparin (UFH) in long-term anticoagulation. Although data are limited in pediatric patients with renal insufficiency, enoxaparin can be used in this population. Data related to its use in hemodialysis (HD) pediatric patients is almost non-existent. A major concern for enoxaparin use in patients with renal insufficiency or for those on HD is bleeding. A few studies in adults showed an increased risk of bleeding, but the risk was similar to that of UFH when the two were compared. This case report describes the use of enoxaparin in an 8-year-old female who is on hemodialysis, without any bleeding or clotting complications. Although systematic trials are needed to support the safety and efficacy of LMWH in pediatric patients with renal dysfunction or on HD, this case will provide limited information for enoxaparin use in this population.
依诺肝素是一种低分子量肝素（LMWH），是治疗小儿静脉血栓栓塞症的主要药物，与使用普通肝素（UFH）进行长期抗凝相比，其依从性更好。尽管肾功能不全小儿患者的数据有限，但依诺肝素可用于该人群。几乎不存在关于其在血液透析（HD）小儿患者中使用的数据。肾功能不全患者或接受血液透析患者使用依诺肝素的一个主要问题是出血。一些针对成人的研究显示出血风险增加，但将二者进行比较时，该风险与普通肝素相似。本病例报告描述了依诺肝素在一名接受血液透析的8岁女性中的使用情况，未出现任何出血或凝血并发症。尽管需要进行系统试验来支持低分子量肝素在肾功能不全小儿患者或接受血液透析患者中的安全性和有效性，但本病例将为该人群使用依诺肝素提供有限的信息。
