Document Detail


Evidence-based treatment recommendations for uremic bleeding.
MedLine Citation:
PMID:  17322926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Uremic bleeding syndrome is a recognized consequence of renal failure and can result in clinically significant sequelae. Although the pathophysiology of the condition has yet to be fully elucidated, it is believed to be multifactorial. This article is a review of both the normal hemostatic and homeostatic mechanisms that operate within the body to prevent unnecessary bleeding, as well as an in-depth discussion of the dysfunctional components that contribute to the complications associated with uremic bleeding syndrome. As a result of the multifactorial nature of this syndrome, prevention and treatment options can include one or a combination of the following: dialysis, erythropoietin, cryoprecipitate, desmopressin, and conjugated estrogens. Here, these treatment options are compared with regard to their mechanism of action, and onset and duration of efficacy. An extensive review of the clinical trials that have evaluated each treatment is also presented. Lastly, we have created an evidence-based treatment algorithm to help guide clinicians through most clinical scenarios, and answered common questions related to the management of uremic bleeding.
Authors:
Stephanie J Hedges; Sarah B Dehoney; Justin S Hooper; Jamshid Amanzadeh; Anthony J Busti
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Nature clinical practice. Nephrology     Volume:  3     ISSN:  1745-8331     ISO Abbreviation:  -     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-26     Completed Date:  2007-03-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101261800     Medline TA:  Nat Clin Pract Nephrol     Country:  England    
Other Details:
Languages:  eng     Pagination:  138-53     Citation Subset:  IM    
Affiliation:
University of Mississippi Medical Center, Jackson, MS, USA.
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MeSH Terms
Descriptor/Qualifier:
Deamino Arginine Vasopressin / therapeutic use
Erythropoietin / therapeutic use
Estrogens, Conjugated (USP) / therapeutic use
Evidence-Based Medicine / methods*
Factor VIII / therapeutic use
Fibrinogen / therapeutic use
Hemorrhage / etiology*,  therapy*
Humans
Kidney Failure / complications
Practice Guidelines as Topic*
Renal Dialysis
Uremia / complications*
von Willebrand Factor / therapeutic use
Chemical
Reg. No./Substance:
0/Estrogens, Conjugated (USP); 0/cryoprecipitate coagulum; 0/von Willebrand Factor; 11096-26-7/Erythropoietin; 16679-58-6/Deamino Arginine Vasopressin; 9001-27-8/Factor VIII; 9001-32-5/Fibrinogen
Comments/Corrections
Comment In:
Nat Clin Pract Nephrol. 2007 Jun;3(6):E2; author reply E3   [PMID:  17525710 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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