Severe Bleeding Complication of Low Molecular Weight Heparin in A Dialysis Patient with Deep Venous Thrombosis

Low-molecular-weight heparin (LMWH), a mixture of polysaccharide molecules, is derived from unfractionated heparin (UFH) by physical and/or chemical processes. Using subcutaneous injections of LMWH to treat patients with deep vein thrombosis has several major advantages over the use of conventional intravenous or subcutaneous UFH therapy. For instance, there is no requirement for laboratory monitoring of activated partial thromboplastin time with LMWH. However, in the report we observed a 65-year-old female with end-stage renal disease and found that she, after receiving anticoagulant treatment with Nadroparin (LMWH), developed bleeding complications. It indicates that the potential bleeding adverse effect of LMWHs should be taken into account when applied to patients with severe renal disease. ( J Intern Med Taiwan 2007; 18: 140-145 )