eGFR or CrCl?

Dear All,

We have recently changed from Dalteparin to Enoxaparin (Inhixa) as our first line LMWH for thromboprophylaxis. When using Dalteparin, we measured renal function using eGFR, however, the Renal team have pointed out that we should use CrCl to establish renal function for Enoxaparin (and we should have done for Dalteparin). 

For those using Enoxaparin as thier first line LMWH, could you let me know if you measure eGFR or CrCl? Thanks.

Bw.

Simon.

Hi Simon

We use CrCl in Cardiff

Becky 

We use eGFR for prophylaxis and crcl for treatment. The rationale being that eGFR is a "good enough" estimate of renal function and, since virtually every patient in the hospital is on it, asking a doctor to do the crcl calculation for every patient is unrealistic. Where it is more important to have a better idea of renal function - when giving treatment doses - we use crcl.. Treatment doses are ordered from pharmacy (mostly) so there is a check available on the calculation, as well as the dosing etc.

It's worth remembering that these are estimates of renal function and skewed in all directions by extremes of age and body weight. The only way to truly assess renal function is to collect pee for 24 hours and analyse it which, believe it or not, was practice when I started out in oncology. And I'm not even that old.

Becs

Fantastic and comprehensive answer from Becs 🙂  We do the same.