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Management of uremic bleeding.

P Couch1, J L Stumpf

  • 1Department of Pharmacy Services, University of Michigan Medical Center, Ann Arbor 48109-0008.

Clinical Pharmacy
|September 1, 1990
PubMed
Summary
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Uremic bleeding, a serious complication of kidney failure, involves platelet dysfunction and can be managed with various treatments. Pharmacologic interventions like desmopressin and conjugated estrogens offer effective solutions for managing bleeding episodes.

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Uremic bleeding is a life-threatening complication in patients with kidney failure.
  • The exact cause is unknown but linked to platelet dysfunction and anemia.
  • Manifestations include epistaxis, purpura, and gastrointestinal bleeding.

Purpose of the Study:

  • To discuss the pathogenesis, clinical manifestations, and management of uremic bleeding.
  • To emphasize the role of pharmacologic interventions in treating this disorder.

Main Methods:

  • Review of existing literature on uremic bleeding.
  • Discussion of various treatment modalities including dialysis, transfusions, and pharmacologic agents.
  • Consideration of adverse effects and duration of action for each therapy.

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Main Results:

  • Dialysis offers short-term relief but doesn't fully correct platelet dysfunction.
  • Red-blood-cell transfusions may reduce bleeding time but carry risks.
  • Pharmacologic agents like cryoprecipitate, desmopressin, and conjugated estrogens have specific indications and durations of action.

Conclusions:

  • Management of uremic bleeding requires a multi-faceted approach.
  • Pharmacologic interventions are crucial for effective treatment.
  • Therapy selection must consider risks, benefits, and desired duration of action.