Bleeding time in Uremia: A useful test to assess clinical bleeding

Authors

  • Dr. R. W. Steiner MD,

    Corresponding author
    1. Renal Unit and the Coagulation Research Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston
    Current affiliation:
    1. Nephrology Research, Room 6200, San Diego Veterans Administration Hospital, 3350 La Jolla Village Drive, San Diego
    • Nephrology Research, Room 6200, San Diego Veterans Administration Hospital, 3350 La Jolla Village Drive, San Diego CA 92161
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  • Cecil Coggins,

    1. Renal Unit and the Coagulation Research Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston
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  • Dr. Angelina C. A. Carvalho

    1. Renal Unit and the Coagulation Research Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston
    Current affiliation:
    1. Veterans Administration Hospital, 111/Room 511, Davis Park, Providence, Rhode Island
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Abstract

Modified Ivy bleeding time (template) and platelet aggregation to ADP, epinephrine, and collagen were studied in 26 uremic patients who had not recently ingested anti-platelet drugs. Regardless of the aggregating agent used, the abnormalities in platelet aggregation were often mild, even with advanced uremia, and frequently less severe than the effects of common anti-platelet drugs. The inhibition of collagen-induced aggregation was significantly correlated with both increased bleeding time and blood urea nitrogen. Platelet aggregation was not discriminative between clinically bleeding and non-bleeding groups of patients, but the bleeding time was helpful in this regard. In certain cases, the aggregometric patterns differed between drug-induced and uremic thrombocytopathies. Platelet aggregometry appears to be of little help clinically in assessing the severity of the uremic bleeding diathesis.

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