Anti-Xa activity of nadroparin after a dose reduction (XANDO)

Low-molecular-weight heparins (LMWHs) are frequently used in the prophylaxis and therapy of venous thromboembolism (VTE) and the prophylaxis of arterial thromboembolism. LMWHs are mainly excreted by the kidneys and may accumulate in patients with renal impairment, leading to an increased anti-Xa activity which is associated with an increased risk of bleeding complications. Current dosage guidelines of the Dutch Federation of Nephrology (NfN) and the Royal Dutch Pharmacists Association (KNMP) recommend a dose reduction in patients with renal impairment, followed by determination of the anti-Xa activity in patients treated for more than three days. The evidence supporting this recommendation is sparse. To date, no data is available about the effect of nadroparin in obtaining an adequate anti-Xa activity in patients with renal impairment (eGFR < 60 ml/min) after dose reduction, but also not in patients with a normal renal function (eGFR > 60 ml/min) treated with a standard therapeutic dose of nadroparin. In this study, we therefore determine the anti-Xa activity after a reduced therapeutic dose of nadroparin in patients with an eGFR < 60 ml/min in comparison with the anti-Xa activity after a standard therapeutic dose of nadroparin in patients with an eGFR > 60 m/min, using the dosage guideline of the Dutch Federation of Nephrology

A blood sample will be drawn by venipuncture 4 hours after the 6th administration of Fraxiparine or the 3rd administration of Fraxodi. Though, blood samples collected 4 hours after the 7th respectively 4th administration are also accepted.

One venous blood sample