- Discussion:
- uremic bleeding is associated with platlet dysfunction and is
corrected with
DDAVP (desmopressin);
- platelets from patients w/ chronic renal failure frequently show
defects of the biochemical responses necessary for aggregation and
secretion, such as an increase in cytoplasmic free-calcium levels;
- both prolongation of bleeding time and severity of anemia correlate
w/ severity of renal failure;
- correction of anemia by transfusion of washed red cells or by treatment
with
erythropoietin can shorten the bleeding time to normal or
nearly normal and may decrease the symptoms of bleeding;
- primary hemostatic defect in uremia is thought to be abnormality of
platelet function, and the types of bleeding reported in some pts
with uremia (purpura, epistaxis, and menorrhagia) are consistent
with this interpretation;
