Q: Is Bivalirudin (Angiomax) dialyzable?
A) Yes
B) No
Answer: A
Bivalirudin is metabolized by many organs in the body including the kidney and liver. Bivalirudin dose should be lowered for infusion in patients who have severe renal insufficiency i.e., with CrCl less than 30 mL/minute. Bivalirudin can be hemodialyzed, so patients already on hemodialysis, paradoxically may require a higher dose to keep adequate aPTT.
#nephrology
#pharmacology
#hematology
References:
1. Warkentin TE, Greinacher A, Koster A. Bivalirudin. Thromb Haemost 2008; 99:830.
2. Di Nisio M, Middeldorp S, Büller HR. Direct thrombin inhibitors. N Engl J Med 2005; 353:1028.
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