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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 65 No. 4, 2011.

Review article

DISORDERS OF HEMOSTASIS IN CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION

ELEONORA GOLUŽA ; Zagreb University Hospital Center, Department of Anesthesiology, Resuscitation
MARIJA GRKOVIĆ TOPALOVIĆ ; Zagreb University Hospital Center, Department of Anesthesiology, Resuscitation
TVRTKO HUDOLIN ; Department of Urology, Zagreb, Croatia
SANJA KONOSIĆ ; Zagreb University Hospital Center, Department of Anesthesiology, Resuscitation
IVA BAČAK KOCMAN ; Zagreb University Hospital Center, Department of Anesthesiology, Resuscitation
MLADEN PERIĆ ; Zagreb University Hospital Center, Department of Anesthesiology, Resuscitation

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Abstract

The presence of end-stage renal disease (ESRD) has been associated with profound clinical effects on hemostasis ranging from thrombosis to bleeding complications. The pathogenesis of uremic bleeding is multifactorial. It has been attributed to platelet dysfunction, the most important feature, particularly platelet-platelet and platelet-vessel wall interactions. Renal replacement therapy has helped reduce bleeding episodes, but the risk of morbidity and mortality due to hemorrhage persists. Abnormalities of blood coagulation and fibrinolysis predispose uremic patients to hypercoagulable state carrying the risk of atherosclerotic cardiovascular disease and thrombotic complications such as thrombosis of the vascular access wall. There are differences in the measurement of various hemostatic parameters in patients with ESRD concerning treatment with either hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). Hemostatic disturbances are overlapped by changes in the coagulation/ fibrinolytic system after renal transplantation (RT). Despite the etiology, renal transplant patients are at an increased risk of thromboembolic events as a consequence of prothrombotic clotting and fibrinolytic abnormalities. This hypercoagulable state is to a large extent associated with immunosuppressive drugs. This review will give a summary of views on hemostasis in patients with ESRD and after RT.

Keywords

hemostasis; chronic renal failure; renal transplantation

Hrčak ID:

89615

URI

https://hrcak.srce.hr/89615

Publication date:

1.3.2011.

Article data in other languages: croatian

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