Use of Low Molecular Weight Heparin (Tinzaparin) to Treat Blood Clots in Patients With Kidney Failure
Venous Thrombosis, Pulmonary Embolism
About this trial
This is an interventional treatment trial for Venous Thrombosis focused on measuring Venous thrombosis, Pulmonary embolism, Kidney failure, Anticoagulants, Heparin, Low-Molecular-Weight
Eligibility Criteria
Inclusion Criteria: Adult patients 18 years of age or older Objectively confirmed VTE requiring anticoagulant therapy, including lower extremity and upper extremity deep vein thrombosis (catheter and non-catheter related, including dialysis access thrombosis [i.e., graft, fistula]); peripheral vein thrombosis (e.g., portal vein, mesenteric vein, cerebral vein thrombosis), and pulmonary embolism Exclusion Criteria: Weight exceeding 105 kg Unstable declining renal function, defined as documented change in creatinine > 20% in the past 3 months or clinical circumstances likely to be associated with change in renal function, such as dehydration or severe intercurrent illness. Where no previous creatinine values exist and the patient is otherwise stable, patients will not be excluded on the basis of unknown previous renal function. Known allergy to heparin/LMWHs or history of heparin induced thrombocytopenia Treatment with UFH, LMWH, danaparoid, oral direct thrombin inhibitors for >48 h Bleeding requiring hospitalization or blood transfusion within 6 months(exception is blood transfusion given in relation to surgical procedures within 6 months) History of intracerebral hemorrhage Known active liver disease (AST or ALT > 3 times the upper limit of normal, or bilirubin > 50 umol/L) Known active peptic ulcer disease, with ongoing symptoms or need for anti-ulcer medical therapy Thrombocytopenia (platelet count of < 100 x 109/L) Ongoing need for antiplatelet agents (clopidogrel, ticlopidine, aspirin > 325 mg daily) Pregnancy or lactation Geographic inaccessibility Unable, or unwilling, to provide written informed consent
Sites / Locations
- St Joseph's Healthcare Hamilton
Arms of the Study
Arm 1
Experimental
1
All patients in this cohort receive treatment with weight-adjusted, standard-dose tinzaparin for treatment of venous thromboembolism. Trough anti-Xa level measurements done on any 2 of days 3, 5 or 7 of treatment. Patients with a trough anti-Xa level > 0.5 IU/mL receive dose adjustment of the tinzaparin.