Removal of lepirudin, a recombinant hirudin, by hemodialysis, hemofiltration, or plasmapheresis.

Lepirudin (recombinant hirudin), a direct thrombin inhibitor, is an effective alternative method of anticoagulation in patients with heparin-induced thrombocytopenia. However, because it is eliminated by the kidneys, the half-life of lepirudin may be substantially prolonged in patients with renal failure. Patients undergoing hemodialysis must be closely monitored, and therapy must be individualized based on each patient's ability to clear the drug.