The Bleeding Disorder of Uræmia

Castaldi, P.A.; Rozenberg, M. C.; Stewart, J. H.

doi:10.1016/s0140-6736(66)91802-2

Cited by 199 publications

(36 citation statements)

References 15 publications

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“…19 In addition to anemia, patients with chronic renal failure are prone to develop infections and hemorrhagic diathesis. 20 In the present study the platelet count was decreased among chronic renal failure patients. Erythropoietin potentiates the effect of megakaryocyte colony stimulating factors, acetlyhydroase (PAF-AH) and paraoxonase (PON1).…”

Section: Discussionsupporting

confidence: 52%

Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters

2017

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Background: Chronic kidney disease (CRD) is a global public health problem, where slowly progressive deterioration in kidney function lead to numerous hematological and biochemical dysfunction which further make the patients vulnerable to cardiovascular morbidity and mortality if appropriate measures is not taken for their control. The aim of present study was to find out the common hematological dysfunction that may occur in the patients of chronic renal failure (CRF) and in the process of dialysis and suggest appropriate measures for their management.Methods: Forty-two patient with CRF and on regular maintenance dialysis and 40 healthy adults were recruited into the study. Hemoglobin concentration, total red cell count, total white blood cell count and platelet count and ESR were assessed for the subjects and controls. Results were analyzed using SPSS 21.0 version.Results: showed that the RBC count, hemoglobin levels and platelets counts are significantly reduced in the patients of chronic renal failure and the process of hemodialysis further decreases the level of all the above mentioned hematological parameters whereas there is slight increase in total leucocyte count but significant increase in ESR was detected.Conclusions: Chronic renal failure is associated with different degrees of abnormality in hematological parameters that needs careful evaluation and management.

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Section: Discussionsupporting

confidence: 52%

Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters

2017

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“…These new insights stimulated the research on the pathogenesis of bleeding tendency in renal failure. This complication frequently observed in uremia could not be fully explained by the well-known defective platelet function [4,6,18]. In 1977 Remuzzi et al [27] studied the PGP synthesis of venous specimens from 2 patients with acute renal failure and of 1 patient with chronic renal insufficiency.…”

Section: Increased Vascular Pgp Releasementioning

confidence: 99%

“…It is a well-known fact that platelet function is fre quently disturbed in patients suffering from terminal renal failure [4,6,18,36]. This alteration is rather com plex and includes a decreased platelet factor 3 availabil ity [18], depressed retention by glass beads [36], and decreased platelet aggregation to various exogenous stimuli in vitro [4,6,36], In 1975 Lindsay et al [20] studied the platelet function in dialyzed and nondialyzed patients with chronic renal failure.…”

Section: Defective Platelet Functionmentioning

confidence: 99%

“…This alteration is rather com plex and includes a decreased platelet factor 3 availabil ity [18], depressed retention by glass beads [36], and decreased platelet aggregation to various exogenous stimuli in vitro [4,6,36], In 1975 Lindsay et al [20] studied the platelet function in dialyzed and nondialyzed patients with chronic renal failure. They examined plate let aggregation by ADP as well as platelet adhesiveness using dialysis membranes in a test cell system.…”

Section: Defective Platelet Functionmentioning

confidence: 99%

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Eicosanoids of Platelets and Vascular Wall in Chronic Renal Insufficiency

Sinzinger

Leithner²

1987

Am J Nephrol

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There is good evidence that retention products accumulating in chronic renal insufficiency influence prostaglandin (PG) synthesis, thus affecting platelet-vascular wall interaction. The vascular PGI2 synthesis is increased and prolonged in vitro, the plasma factor activity enhanced. A defective platelet function is frequently observed; it is completely restored by peritoneal dialysis, but only partially by hemodialysis. The sensitivity of platelets to PGI2 and its plasmatic degradation are unchanged. There is evidence of a shift of arachidonic acid metabolism from cyclooxygenase to lipoxygenase. These changes may be attributed to undialyzable plasma constituents, the ‘middle molecules’.

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“…It has been shown that some metabolites in uremic plasma inactivate platelet fac tor 3, which is essential in the intrinsic mechanism of coagulation [8,11,17]. In addition, platelet adhesiveness and aggregability are reduced in renal failure [14]. These anomalies as well as the defective release of factor 3 are corrected by hemodialysis [95].…”

Section: Bleeding In Uremiamentioning

confidence: 99%

Hematologic Disorders in Renal Failure

Naets¹

1975

Nephron

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Anemia is a frequent complication of renal failure. As in anemias of other origin, the resulting tissular hypoxia is partially compensated by an increased production of 2,3-diphosphoglycerate in red cells and a shift to the right of the oxygen hemoglobin dissociation curve. Two mechanisms are implicated in this anemia: increased hemolysis and depressed production of red cells. Decreased production of erythropoietin is probably the cause of reduced erythropoiesis, but the role of uremic intoxication has not been unequivocally excluded. In the course of chronic hemodialysis, iron deficiency anemia and occasionally hypersplenism develop. It is noteworthy that blood requirements in anephric patients are two to three times greater than those of nonanephric hemodialyzed patients. Accordingly, bilateral nephrectomy should be restricted to carefully selected cases. At the present time, androgens seem to be the best treatment of renal anemia. Qualitative anomalies of platelets are the main factor responsible for uremic bleeding and are corrected by hemodialysis.

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The Bleeding Disorder of Uræmia

Cited by 199 publications

References 15 publications

Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters

Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters

Eicosanoids of Platelets and Vascular Wall in Chronic Renal Insufficiency

Hematologic Disorders in Renal Failure

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