Tranexamic acid(TNA) increases peritoneal ultrafiltration(UF) volume in patients on CAPD with UF loss.

Kuriyama, Satoru; Nakayama, Masaaki; Tomonari, Haruo; Numata, Miwako; Hayashi, Fumihiro; Hikita, Miho; Kawaguchi, Yoshindo; Hosoya, Tatsuo

doi:10.4009/jsdt.30.1369

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…9 Actually, at some hospitals, TNA is prescribed on a trial basis to PD patients. 10 Care is required with respect to the quantity of TNA administered to PD patients, and the subjective symptoms relating to sight also require attention.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic acid-induced visual impairment in a hemodialysis patient

Kitamura

Matsui

Itoh

et al. 2003

Clinical and Experimental Nephrology

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We report a case of overdosage of tranexamic acid (TNA), which was suggested as the cause of visual impairment in a 56-year-old man. He had been undergoing chronic hemodialysis for 1 year, following 10 years of peritoneal dialysis. He had been hospitalized for an emergency operation for a bleeding ulcer of the stomach and duodenum. After the operation, he experienced a gradual loss of sight over about 1 week, although his general condition was good. He received intravenous injections of TNA as a hemostat during hospitalization for the operation. Two weeks after the operation he became blind. Retinography was flat and his visual field had become narrowed. On fluorescein angiography, microgranular hyperfluorescence, which indicated malfunction of the pigmented layer of the retina, was observed. No abnormality of the brain or the optic nerve was shown by magnetic resonance imaging. Concentrations of vitamins and trace minerals in the blood were within the normal ranges. Administration of vitamins A and B(12) did not improve his sight. However, discontinuation of TNA rapidly restored his sight, within a few days. He had received TNA once before because of bleeding ulcer, and his sight had been impaired at that time. Based on the repeated episodes, it was strongly suggested that an overdose of TNA in this dialysis patient caused the sight disturbance. Because TNA is metabolized by the kidney, caution is necessary when prescribing TNA for patients with renal failure.

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Section: Discussionmentioning

confidence: 99%

Tranexamic acid-induced visual impairment in a hemodialysis patient

Kitamura

Matsui

Itoh

et al. 2003

Clinical and Experimental Nephrology

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“…Recently, studies have reported that tranexamic acid administration increases the trans ‐peritoneally removed fluid (27) and it is suggested that suppression of TLA is involved in this mechanism (15). Tranexamic acid is known to strongly suppress the effect of bradykinin, and putting together the fact that bradykinin is a strong promoter of active transport of bovine mesenteric lymph ducts, then the clinical effect of tranexamic acid may result from the suppression of the active transport of lymph duct fluid‐removal failure.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Translymphatic Fluid Absorption Using Technetium‐99m Human Serum Albumin Diethylenetriamine Pentaacetic Acid in Continuous Ambulatory Peritoneal Dialysis Patients

et al. 2004

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We have established a new method of measuring translymphatic fluid absorption (TLA) using technetium-99m ((99m)Tc) human serum albumin diethylenetriamine pentaacetic acid ((99m)Tc-HSAD) that can be used commonly in clinical practice. This new method was applied in 13 continuous ambulatory peritoneal dialysis patients (11 males and two females) who had various peritoneal permeability and capacities for peritoneal transport of water. (99m)Tc-HSAD 740MBq was injected in 2 L of peritoneal dialysis fluid with 2.5% glucose, mixed well, and administered intraperitoneally. The fluid was drained extraperitoneally after 4 h and TLA was determined by the in vivo loss of (99m)Tc-HSAD. TLA was 1.41 +/- 1.11 mL/min (mean +/- SD; range, 0.27-3.69 mL/min). The estimated reduction rate by TLA in trans-peritoneally removed fluid ranged from 14.2 to 84.4%, indicating that TLA could have an extremely significant negative effect in some cases on total drainage volume. The present study, using new tracer (99m)Tc-HSAD, could confirm a large individual difference in TLA, indicating TLA as an important contributing factor for fluid-removal failure in continuous ambulatory peritoneal dialysis patients.

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“…A part of this work was presented at the VIIIth Congress of the International Society for Peritoneal Dialysis, Seoul, Korea, 1998 (20). A part of the preliminary data obtained in the CAPD patients with UF loss was also presented elsewhere (21).…”

Section: A C K N O W L E D G M E N Tmentioning

confidence: 99%

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

et al. 1999

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Objective The preservation of ultrafiltration (UF) capacity is crucial to maintaining long-term continuous ambulatory peritoneal dialysis (CAPD). The aim of the present study was to investigate whether the antiplasmin agent tranexamic acid (TNA) increases UF volume in CAPD patients. Patients and Methods Fifteen patients on CAPD, 5 with UF loss and 10 without UF loss, were recruited for the study. The effect of TNA was evaluated with respect to changes in UF volume, peritoneal permeability, peritoneal clearance, bradykinin (BK), and tissue plasminogen activator (tPA) concentration. Setting Dialysis unit of the Saiseikai Central Hospital. Results In patients with UF loss, 2 weeks of treatment with oral TNA produced a significant increase in UF volume in all subjects (5/5). TNA also produced a significant increase in peritoneal clearances of urea and creatinine (Cr). However, the peritoneal equilibration test (PET) revealed that TNA had no effect on dialysate/plasma (D/P) Cr, Kt/V, or the protein catabolic rate (PCR). TNA also had no effect on net glucose reabsorption. In contrast, significant decreases in BK and blood tPA concentrations in response to TNA treatment were noted. BK concentration in drainage fluid was also reduced. In the case of patients without UF loss, TNA produced an increase in UF volume in 70% (7/10). However, no differences were found in blood and drainage BK and tPA concentrations between the TNA treatment and nontreatment periods in these patients. A comparison of basal BK and tPA concentration showed that there were no differences in these parameters between patients with UF loss and those without loss of UF. Furthermore, TNA given intraperitoneally to a patient also produced a marked increase in UF volume. Conclusion The present study suggests that TNA enhances UF volume in patients both with and without UF loss. Since TNA did not affect peritoneal permeability and glucose reabsorption, the mechanism by which TNA exerts an enhancing action on UF is largely unknown. We speculate that it may be associated with suppression of the BK and/or tPA system, at least in patients with UF loss.

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Tranexamic acid(TNA) increases peritoneal ultrafiltration(UF) volume in patients on CAPD with UF loss.

Cited by 3 publications

References 5 publications

Tranexamic acid-induced visual impairment in a hemodialysis patient

Tranexamic acid-induced visual impairment in a hemodialysis patient

Measurement of Translymphatic Fluid Absorption Using Technetium‐99m Human Serum Albumin Diethylenetriamine Pentaacetic Acid in Continuous Ambulatory Peritoneal Dialysis Patients

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

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