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Related Experiment Video

Updated: Feb 9, 2026

Author Spotlight: Understanding the Effect of Herbal-Cake-Separated Moxibustion in Rats with Renal Faliure
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Hemostatic Abnormalities in Severe Renal Failure: Do They Bark or Bite?

A Mohapatra1, A T Valson1, B Gopal2

  • 1Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.

Indian Journal of Nephrology
|June 5, 2018
PubMed
Summary

Hemostatic abnormalities are uncommon in predialysis chronic kidney disease (CKD) Stages 4 and 5. The only common issue found was thrombocytopenia, which did not correlate with the severity of uremia.

Keywords:
Bleeding timeHarris syndromechronic kidney diseasehemostasismacrothrombocytopenia

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Area of Science:

  • Nephrology
  • Hematology
  • Internal Medicine

Background:

  • Abnormal primary hemostasis is a suspected major cause of uremic bleeding.
  • Understanding hemostatic disorders in chronic kidney disease (CKD) is crucial for managing bleeding risks.

Purpose of the Study:

  • To determine the prevalence and characteristics of primary and secondary hemostatic disorders in CKD Stages 4 and 5 patients.
  • To investigate the association between these disorders and the degree of uremia.

Main Methods:

  • Prospective recruitment of 45 predialysis CKD Stages 4 and 5 patients.
  • Measurement of platelet count, bleeding time (BT), Factor VIII, von Willebrand factor (vWF) antigen and activity, and coagulation times (PT, aPTT).

Main Results:

  • Thrombocytopenia was more prevalent in patients from West Bengal (57.7%) but associated with normal BT (Harris syndrome).
  • Other hemostatic abnormalities were infrequent: vWF:RCo/vWF:Ag ratio (8.8%), BT (2.2%), PT (15.6%), and aPTT (11.1%).
  • Prevalence of hemostatic abnormalities, excluding thrombocytopenia, did not differ between CKD Stages 4 and 5 and were not linked to uremia severity.

Conclusions:

  • Hemostatic abnormalities are generally uncommon in Stages 4-5 CKD.
  • Thrombocytopenia, particularly constitutional macrothrombocytopenia, may occur but often presents with normal bleeding times.
  • The degree of uremia does not appear to significantly influence hemostatic function in these CKD stages, except possibly for thrombocytopenia.