Treatment of uraemic bleeding with conjugated oestrogen

A conjugated oestrogen preparation ('Premarin') was given to 6 uraemic patients with abnormal bleeding tendency in whom bleeding time was more than 30 min despite their being on chronic dialysis. In 4 patients the bleeding time became normal after 2 to 5 days of premarin therapy. In 1 of the 4 the prolonged bleeding time was repeatedly restored to normal (less than 7 min) after a single dose of premarin (25 mg). Bleeding time remained normal for 3 to 10 days after discontinuation of premarin. Bleeding time was significantly shortened (11 min) in the other 2 patients after 7 and 9 days of treatment. There was no consistent improvement in platelet aggregation nor increase in plasma factor-VIII-ristocetin cofactor activity during premarin therapy. 5 patients underwent surgery without abnormal bleeding. There were no side effects associated with premarin administration. Premarin treatment may be beneficial to uraemic patients with abnormal bleeding.