This review of enoxaparin compared the bleeding events rates in patients with moderate renal impairment (CrCl of 30-50 ml/min) to those patients with normal renal function (CrCl > 80 ml/min). Enoxaparin was dosed at 1 mg/kg bid or 1.5 mg/kg OD. The primary outcome of major bleeding occurred in 22.0% of the renal impairment group vs 5.7% of the normal renal function group. There was no evidence of recurrent thromboembolism in either group. Given the frequency of enoxaparin use, this study highlights the need for further investigation regarding the appropriate dosing in patients with moderate renal impairment.