For the management of VTE in a patient with severe renal insufficiency, which of the following is appropriate?

For patients with severe renal insufficiency, the management of venous thromboembolism (VTE) requires careful consideration of drug pharmacokinetics and the risks of accumulating medications. Enoxaparin, a low molecular weight heparin (LMWH), is frequently utilized in VTE management and has specific dosing recommendations for patients with renal impairment.

In cases of severe renal impairment, the dosing of enoxaparin can be adjusted based on renal function to minimize the risk of accumulation and bleeding. While enoxaparin is cleared primarily by the kidneys, dose adjustments allow for safer use in this patient population, making it a viable option for treatment.

Other options, such as warfarin therapy alone, can take time to achieve therapeutic anticoagulation and often require bridging with other anticoagulants, which is less ideal in patients with significant renal issues. Fondaparinux is contraindicated in severe renal impairment, as its clearance is also renal-dependent. Dabigatran is not recommended in patients with severe renal insufficiency due to increased risk of bleeding and accumulation.

Therefore, enoxaparin stands out as an appropriate choice for managing VTE in patients with severe renal insufficiency, owing to its adaptability in dosing and established safety profile