Renal disease induced coagulopathy - Revision history

Rossdonaldson1: Redirected page to Uremic bleeding syndrome

2015-11-08T11:47:30Z

Redirected page to Uremic bleeding syndrome

← Older revision		Revision as of 11:47, 8 November 2015
Line 1:		Line 1:
	~~==Background==~~		#REDIRECT[[Uremic bleeding syndrome]]
	*Uremic toxins inhibit platelet aggregation
	**Disrupts vWF
	**PT/PTT normal, but bleeding time elevated
	*Dialysis filter may cause thrombocytopenia

	~~==Clinical Features==~~

	~~==Differential Diagnosis==~~
	~~{{Increased bleeding DDX}}~~

	~~==Diagnosis==~~
	~~==Treatment==~~
	#~~Acute dialysis~~
	#*[[~~pRBCs]]~~
	~~#**Raising HCT to above 25-30% improves bleeding time~~
	~~#*[[Desmopressin]]~~
	~~#**Simplest and least toxic acute treatment~~
	~~#**Increases release of factor VIII:von Willebrand factor multimers~~
	~~#**0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.~~
	~~#**Onset of action ~1hr, duration of action ~4-24hr~~
	~~#Estrogen~~
	~~#*Unclear mechanism of action~~
	~~#*Onset of action within 1d~~
	~~#*Options~~
	~~#**Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily~~
	~~#[[Cryoprecipitate]]~~
	~~#*Only indicated for life-threatening~~ bleeding ~~resistant to DDAVP and blood tranfusion~~
	~~#*10 bags over 30 minutes~~
	~~#[[Platelet transfusion]]~~
	~~#*Minimally effective because infused platelets quickly acquire the uremic defect~~
	~~#*Only use when uncontrolled hemorrhage~~
	~~#Topical Hemostatic Agents~~
	~~#*Gelatin - Gelfoam or Surgifoam~~
	~~#*Thrombin - Floseal~~

	~~==Disposition==~~

	~~==See Also==~~
	*[[Coagulopathy (Main)]]

	~~==References==~~

	~~[[Category:Heme/Onc~~]]

Rossdonaldson1: /* Treatment */

2015-06-10T12:52:12Z

Treatment

← Older revision		Revision as of 12:52, 10 June 2015
Line 15:		Line 15:
	#*[[pRBCs]]		#*[[pRBCs]]
	#**Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time
	#*[[Desmopressin]][		#*[[Desmopressin]]
	#**Simplest and least toxic acute treatment		#**Simplest and least toxic acute treatment
	#**Increases release of factor VIII:von Willebrand factor multimers		#**Increases release of factor VIII:von Willebrand factor multimers

Rossdonaldson1: /* Treatment */

2015-06-10T12:52:03Z

Treatment

← Older revision		Revision as of 12:52, 10 June 2015
Line 13:		Line 13:
	==Treatment==		==Treatment==
	#Acute dialysis		#Acute dialysis
	#*pRBCs		#*[[pRBCs]]
	#**Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time
	#*Desmopressin		#*[[Desmopressin]][
	#**Simplest and least toxic acute treatment		#**Simplest and least toxic acute treatment
	#**Increases release of factor VIII:von Willebrand factor multimers		#**Increases release of factor VIII:von Willebrand factor multimers
Line 25:		Line 25:
	#*Options		#*Options
	#**Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily		#**Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily
	#Cryoprecipitate		#[[Cryoprecipitate]]
	#*Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion		#*Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion
	#*10 bags over 30 minutes		#*10 bags over 30 minutes
	#[[Platelet transfusion]]		#[[Platelet transfusion]]
	#*Minimally effective because infused ~~plts~~ quickly acquire the uremic defect		#*Minimally effective because infused platelets quickly acquire the uremic defect
	#*Only use when uncontrolled hemorrhage		#*Only use when uncontrolled hemorrhage
	#Topical Hemostatic Agents		#Topical Hemostatic Agents

Rossdonaldson1: /* Treatment */

2015-06-10T12:51:34Z

Treatment

← Older revision		Revision as of 12:51, 10 June 2015
Line 13:		Line 13:
	==Treatment==		==Treatment==
	#Acute dialysis		#Acute dialysis
	##pRBCs		#*pRBCs
	###Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time
	##Desmopressin		#*Desmopressin
	###Simplest and least toxic acute treatment		#**Simplest and least toxic acute treatment
	###Increases release of factor VIII:von Willebrand factor multimers		#**Increases release of factor VIII:von Willebrand factor multimers
	###0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.		#**0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.
	###Onset of action ~1hr, duration of action ~4-24hr		#**Onset of action ~1hr, duration of action ~4-24hr
	#Estrogen		#Estrogen
	##Unclear mechanism of action		#*Unclear mechanism of action
	##Onset of action within 1d		#*Onset of action within 1d
	##Options		#*Options
	###Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily		#**Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily
	#Cryoprecipitate		#Cryoprecipitate
	##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion		#*Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion
	##10 bags over 30 minutes		#*10 bags over 30 minutes
	#[[Platelet transfusion]]		#[[Platelet transfusion]]
	##Minimally effective because infused plts quickly acquire the uremic defect		#*Minimally effective because infused plts quickly acquire the uremic defect
	##Only use when uncontrolled hemorrhage		#*Only use when uncontrolled hemorrhage
	#Topical Hemostatic Agents		#Topical Hemostatic Agents
	##Gelatin - Gelfoam or Surgifoam		#*Gelatin - Gelfoam or Surgifoam
	##Thrombin - Floseal		#*Thrombin - Floseal

	==Disposition==		==Disposition==

Rossdonaldson1 at 12:49, 10 June 2015

2015-06-10T12:49:14Z

← Older revision		Revision as of 12:49, 10 June 2015
Line 5:		Line 5:
	*Dialysis filter may cause thrombocytopenia		*Dialysis filter may cause thrombocytopenia

			==Clinical Features==

			==Differential Diagnosis==
			{{Increased bleeding DDX}}

			==Diagnosis==
	==Treatment==		==Treatment==
	#Acute dialysis		#Acute dialysis
Line 22:		Line 28:
	##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion		##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion
	##10 bags over 30 minutes		##10 bags over 30 minutes
	#~~Plt~~ transfusion		#[[Platelet transfusion]]
	##Minimally effective ~~b/c~~ infused plts quickly acquire the uremic defect		##Minimally effective because infused plts quickly acquire the uremic defect
	##Only use when uncontrolled hemorrhage		##Only use when uncontrolled hemorrhage
	#Topical Hemostatic Agents		#Topical Hemostatic Agents
	##Gelatin - Gelfoam or Surgifoam		##Gelatin - Gelfoam or Surgifoam
	##Thrombin - Floseal		##Thrombin - Floseal

			==Disposition==

	==See Also==		==See Also==
	*[[Coagulopathy (Main)]]		*[[Coagulopathy (Main)]]

	==~~Source~~==		==References==
	*Tintinalli
	*UpToDate

	[[Category:Heme/Onc]]		[[Category:Heme/Onc]]

Rossdonaldson1: Rossdonaldson1 moved page Renal Disease Induced Coagulopathy to Renal disease induced coagulopathy

2015-06-10T12:47:43Z

Rossdonaldson1 moved page Renal Disease Induced Coagulopathy to Renal disease induced coagulopathy

← Older revision	Revision as of 12:47, 10 June 2015
(No difference)

ManpreetS2006: Minor edits

2014-01-12T22:56:58Z

Minor edits

← Older revision		Revision as of 22:56, 12 January 2014
Line 8:		Line 8:
	#Acute dialysis		#Acute dialysis
	##pRBCs		##pRBCs
	###Raising ~~hct~~ to above 25-30% improves bleeding time		###Raising HCT to above 25-30% improves bleeding time
	##Desmopressin		##Desmopressin
	###Simplest and least toxic acute treatment		###Simplest and least toxic acute treatment
	###Increases release of factor VIII:von Willebrand factor multimers		###Increases release of factor VIII:von Willebrand factor multimers
	###0.3 mg/kg IV (preferred) or SC (max 20mg)		###0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.
	###Onset of action ~1hr, duration of action ~4-24hr		###Onset of action ~1hr, duration of action ~4-24hr
	#Estrogen		#Estrogen
Line 21:		Line 21:
	#Cryoprecipitate		#Cryoprecipitate
	##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion		##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion
			##10 bags over 30 minutes
	#Plt transfusion		#Plt transfusion
	##Minimally effective b/c infused plts quickly acquire the uremic defect		##Minimally effective b/c infused plts quickly acquire the uremic defect
			##Only use when uncontrolled hemorrhage
			#Topical Hemostatic Agents
			##Gelatin - Gelfoam or Surgifoam
			##Thrombin - Floseal

	==See Also==		==See Also==

ManpreetS2006: Minor edit

2014-01-12T22:44:56Z

Minor edit

← Older revision		Revision as of 22:44, 12 January 2014
Line 2:		Line 2:
	*Uremic toxins inhibit platelet aggregation		*Uremic toxins inhibit platelet aggregation
	**Disrupts vWF		**Disrupts vWF
			**PT/PTT normal, but bleeding time elevated
	*Dialysis filter may cause thrombocytopenia		*Dialysis filter may cause thrombocytopenia

ManpreetS2006: Minor edit

2014-01-12T22:43:37Z

Minor edit

← Older revision		Revision as of 22:43, 12 January 2014
Line 1:		Line 1:
	==Background==		==Background==
	*Uremic toxins inhibit platelet aggregation		*Uremic toxins inhibit platelet aggregation
			**Disrupts vWF
	*Dialysis filter may cause thrombocytopenia		*Dialysis filter may cause thrombocytopenia

Rossdonaldson1: Created page with "==Background== Uremic toxins inhibit platelet aggregation Dialysis filter may cause thrombocytopenia ==Treatment== #Acute dialysis ##pRBCs ###Raising hct to above 25-30% im..."

2014-01-07T13:25:58Z

Created page with "==Background== *Uremic toxins inhibit platelet aggregation *Dialysis filter may cause thrombocytopenia ==Treatment== #Acute dialysis ##pRBCs ###Raising hct to above 25-30% im..."

New page

==Background==
*Uremic toxins inhibit platelet aggregation
*Dialysis filter may cause thrombocytopenia

==Treatment==
#Acute dialysis
##pRBCs
###Raising hct to above 25-30% improves bleeding time
##Desmopressin
###Simplest and least toxic acute treatment
###Increases release of factor VIII:von Willebrand factor multimers
###0.3 mg/kg IV (preferred) or SC (max 20mg)
###Onset of action ~1hr, duration of action ~4-24hr
#Estrogen
##Unclear mechanism of action
##Onset of action within 1d
##Options
###Conjugated estrogen 0.6mg/kg IV or 2.5-25mg PO daily
#Cryoprecipitate
##Only indicated for life-threatening bleeding resistant to DDAVP and blood tranfusion
#Plt transfusion
##Minimally effective b/c infused plts quickly acquire the uremic defect

==See Also==
*[[Coagulopathy (Main)]]

==Source==
*Tintinalli
*UpToDate

[[Category:Heme/Onc]]

Renal disease induced coagulopathy - Revision history

Rossdonaldson1: Redirected page to Uremic bleeding syndrome

Rossdonaldson1: /* Treatment */

Rossdonaldson1: /* Treatment */

Rossdonaldson1: /* Treatment */

Rossdonaldson1 at 12:49, 10 June 2015

Rossdonaldson1: Rossdonaldson1 moved page Renal Disease Induced Coagulopathy to Renal disease induced coagulopathy

ManpreetS2006: Minor edits

ManpreetS2006: Minor edit

ManpreetS2006: Minor edit

Rossdonaldson1: Created page with "==Background== *Uremic toxins inhibit platelet aggregation *Dialysis filter may cause thrombocytopenia ==Treatment== #Acute dialysis ##pRBCs ###Raising hct to above 25-30% im..."

Rossdonaldson1: Created page with "==Background== Uremic toxins inhibit platelet aggregation Dialysis filter may cause thrombocytopenia ==Treatment== #Acute dialysis ##pRBCs ###Raising hct to above 25-30% im..."