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Uremic Bleeding

- Discussion:
    - uremic bleeding is associated with platlet dysfunction and is corrected with DDAVP (desmopressin);
    - platelets from patients w/ chronic renal failure frequently show defects of the biochemical responses necessary for aggregation and secretion, such as an increase in cytoplasmic free-calcium levels;
    - both prolongation of bleeding time and severity of anemia correlate w/ severity of renal failure;
    - correction of anemia by transfusion of washed red cells or by treatment with erythropoietin can shorten the bleeding time to normal or nearly normal and may decrease the symptoms of bleeding;
    - primary hemostatic defect in uremia is thought to be abnormality of platelet function, and the types of bleeding reported in some pts with uremia (purpura, epistaxis, and menorrhagia) are consistent with this interpretation