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Las dosis moderadas de aspirina y el riesgo de sangrado en la insuficiencia renal
Lancet (London, England)
|February 22, 1986
Resumen
La aspirina prolongó los tiempos de sangrado en pacientes urémicos sometidos a hemodiálisis, a pesar de no afectar a individuos sanos. Esto pone de relieve la necesidad de una cuidadosa evaluación del riesgo-beneficio antes de usar aspirina para prevenir la trombosis arteriovenosa de derivación.
Área de la Ciencia:
- Nefrología Nefrología.
- Hematología Hematología.
- Farmacología Farmacología.
Sus antecedentes:
- Los pacientes urémicos presentan tendencias hemorrágicas debido a la disfunción plaquetaria.
- Los pacientes en hemodiálisis se enfrentan a riesgos trombóticos paradójicos, particularmente con las derivaciones arteriovenosas.
Objetivo del estudio:
- Para investigar el impacto de la aspirina en la función hemostática en pacientes urémicos en hemodiálisis crónica.
- Evaluar la eficacia de la aspirina en la prevención de la trombosis de derivación arteriovenosa en esta población.
Principales métodos:
- Un estudio que involucró a 29 pacientes urémicos en hemodiálisis crónica con tiempos de sangrado normales o ligeramente prolongados.
- Administración de 100 mg/m2 de aspirina y evaluación del tiempo de sangrado y la inhibición de la ciclooxigenasa plaquetaria.
Principales resultados:
- La aspirina prolongó significativamente los tiempos de sangrado en pacientes urémicos, a diferencia de los controles sanos.
- La aspirina abolió la generación de tromboxano A2 tanto en las plaquetas uraémicas como en las plaquetas de control, lo que sugiere un mecanismo no diferencial.
- No se identificó un papel significativo para los productos de la lipoxigenasa o el factor VIII del factor von Willebrand.
Conclusiones:
- La administración de aspirina requiere una evaluación exhaustiva del riesgo-beneficio en pacientes urémicos en hemodiálisis.
- Los hallazgos sugieren precaución al considerar la aspirina para la prevención de la trombosis de derivación arteriovenosa en este grupo de pacientes.
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