Fibrinolytic Capacity in Hemodialysis Patients Treated with Recombinant Human Erythropoietin

Aunsholt, N.Aa.; Ahlbom, G.; Steffensen, G.; Glud, Torben

doi:10.1159/000187060

Cited by 18 publications

(19 citation statements)

References 8 publications

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“…4c), the impaired surfaces of the cystine crystals display numerous scattered holes similar to wormholes. The limited effect of captopril on cystine crystals in comparison to that observed for tiopronine and d-penicillamine is in agreement with clinical findings suggesting the failure of captopril in preventing stone recurrence (Aunsholt & Ahlbom, 1990). Indeed, in our crystalluria studies, we were unable to demonstrate any significant effect of captopril for reducing cystine crystal volume, while a significant decrease in crystal volume was observed in patients treated by either tiopronine or d-penicillamine (Daudon et al, 2003).…”

Section: Discussionsupporting

confidence: 89%

Therapy modifies cystine kidney stones at the macroscopic scale. Do such alterations exist at the mesoscopic and nanometre scale?

et al. 2014

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International audienceWith an incidence of 1:7000 births, cystinuria, the most frequent cause of stone formation among genetic diseases, represents a major medical problem. Twentyfive cystine stones randomly selected from cystinuric patients were investigated. From a crystallographic point of view, cystine stones are composed of micrometre size crystallites, which are made up of an aggregation of nanocrystals. Through scanning electron microscopy, the morphology and size of the crystallites have been described, while the size of the nanocrystals was investigated by means of powder neutron diffraction. Powder neutron diffraction analysis and/or scanning electron microscopy examination of cystine stones provide evidence that usual alkalinization by sodium bicarbonate associated with high diuresis significantly reduces the size of both nanocrystals and crystallites, while for other treatments, including alkalinizing drugs and thiol derivatives, the data suggest mainly changes in the topology of crystallites. Alkalinization with sodium bicarbonate affects cystine kidney stones at the mesoscopic and nanoscopic scales, while other medical treatments only alter their surface. Such an approach may help to assess the interaction between drugs and cystine stones in cystinuric patients

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Section: Discussionsupporting

confidence: 89%

Therapy modifies cystine kidney stones at the macroscopic scale. Do such alterations exist at the mesoscopic and nanometre scale?

et al. 2014

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“…The majority of the papers (12 of 17) reported no change in fibrinogen levels, while 4 of 17 papers reported increases and 1 of 17 papers reported decreases in fibrinogen levels. The four papers in which fibrinogen levels were increased were from three groups of investigators [8,17,46,49]; the references by Aunsholt et al [8,46] appear to represent duplicate publications of the same (or similar) data. The latter investigators reported a 20% increase in fibrinogen levels following intravenous, but not subcutaneous, administration of Epoetin alfa.…”

Section: Effects Of Epoetin Alfa Therapy On Platelets and Platelet Fumentioning

confidence: 99%

Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

1998

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Epoetin alfa is the cornerstone of anemia therapy in patients with end-stage renal disease. In addition to stimulating erythropoiesis, Epoetin alfa has been demonstrated to affect hemostasis. Such effects may be important because patients with chronic renal failure have a bleeding diathesis that is multifactorial in origin. Therefore, a computer literature search on the relationship between Epoetin alfa therapy for anemia in patients with end-stage renal disease and platelets, coagulation, coagulation inhibitors, and fibrinolysis was performed. All articles and abstracts reporting original data in the English language on Epoetin alfa and its effect on hemostasis were reviewed. The literature suggests that the effects of Epoetin alfa on the coagulation cascade are of minimal clinical importance. However, Epoetin alfa transiently increases the number of circulating platelets and improves platelet function, and these effects are associated with a return of the bleeding time towards normal.

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“…A transient increase in thrombin AT-III and a decrease in proteins C and S have been reported following epoietin administration [53,54], but questioned by others [22,55]. An increase in PAI-1 and a significant decrease in tPA have also been noted [56], suggesting a potential role in the hypercoagulation and the fibrinolytic disorder that occurs in ESRD patients on epoietin replacement [57]. Whether the customary subcutaneous administration of epoietin to patients on peritoneal dialysis as opposed to its usual intravenous administration to patients on hemodialysis contributes to the changes reported in CAPD patients also deserves prospective evaluation.…”

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confidence: 99%

Does the Choice of Renal Replacement Therapy Adversely Affect the Hypercoagulability Associated with Renal Disease?

Assouad

Eknoyan²

1998

Am J Nephrol

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Both a bleeding diathesis and a tendency to hypercoagulability occur in the course of renal disease. More common and consistent in occurrence during the progression of renal failure to end-stage renal disease is the hemostatic defect. The principal cause of this abnormality is the uremic state and, as a rule, it is reversible following the institution of adequate renal replacement therapy and correction of the anemia with epoietin. By contrast, the tendency to hypercoagulability is usually encountered in patients with the nephrotic syndrome and shows a correlation to the degree of hypoalbuminemia, being more evident at serum albumin levels of < 2 g/dl. Although the coagulopathy is complex in pathogenesis, a defect in the fibrinolytic process plays a critical role in its development. A tendency to pro-thrombosis due to abnormal fibrinolysis has been identified also in patients on renal replacement therapy with continuous ambulatory peritoneal dialysis (CAPD). The observed coagulation abnormalities resemble those of the nephrotic syndrome. Although its etiology remains undefined, a role for the albumin losses in the peritoneal dialysate has been implicated in the prothrombotic state that occurs in some CAPD patients.

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Fibrinolytic Capacity in Hemodialysis Patients Treated with Recombinant Human Erythropoietin

Cited by 18 publications

References 8 publications

Therapy modifies cystine kidney stones at the macroscopic scale. Do such alterations exist at the mesoscopic and nanometre scale?

Therapy modifies cystine kidney stones at the macroscopic scale. Do such alterations exist at the mesoscopic and nanometre scale?

Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

Does the Choice of Renal Replacement Therapy Adversely Affect the Hypercoagulability Associated with Renal Disease?

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