Bleeding in renal failure: a possible cause.

Nerrmann, R P; Marshall, Lorraine R.; Hurst, P.

doi:10.1136/bmj.1.6076.1601-b

Cited by 19 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20] in renal failure has previously been reported. In contrast to our findings, Kazalchkine et al [20] described decreased V III: Rcof concentrations in patients with uremia and un der hemodialysis, whereas Herrmann et al [12] reported normal values in the same conditions. The reason for these discrepancies remains obscure.…”

Section: Discussioncontrasting

confidence: 55%

Factor VIII Activity in Chronic Renal Disease

Wegmüller¹,

Grüninger²,

Furlan³

et al. 1981

Nephron

View full text Add to dashboard Cite

F VIII coagulant, F VHI-related antigen and F VIII ristocetin cofactor activity were significantly increased in 68 patients with various chronic renal diseases. All three F VIII functions correlated generally well with each other. A striking relationship between some F VIII activities and serum creatinine was detectable in patients with glomerulonephritis and kidney transplants, with mild or moderate renal insufficiency. This correlation was no longer present in terminal renal failure. The results suggest that in initial stages of renal disease elevated F VIII levels may be attributable to glomerular endothelial damage. In terminal renal failure, however, increased F VIII concentrations seem to result from nonspecific causes related to uremia such as acute phase reactions.

show abstract

Section: Discussioncontrasting

confidence: 55%

Factor VIII Activity in Chronic Renal Disease

Wegmüller¹,

Grüninger²,

Furlan³

et al. 1981

Nephron

View full text Add to dashboard Cite

show abstract

“…Furthermore, platelet aggregation in response to ristocetin was shown to be normal in the present study, at variance with the findings of Kazatchkine and coworkers (1976), who claimed factor VIII von Wille- brand factor to play a substantial role in ureamic bleeding. Our findings support those of Remuzzi (1977), Ruggeri (1977) and Herrman (1977) and their respective coworkers, finding normal to increased levels of von Willebrand factor in uraemia.…”

Section: Discussionsupporting

confidence: 92%

Normalization of fibrin induced platelet aggregation in uraemic patients undergoing haemodialysis

Rygh

Brosstad

Björnson

1983

Scandinavian Journal of Haematology

View full text Add to dashboard Cite

Platelet aggregation in response to ADP, collagen, ristocetin and polymerizing des‐AA fibrin monomers was studied in six patients in chronic, stable, renal failure on maintenance haemodialysis. Fibrin induced aggregation was markedly inhibited prior to but normalized after dialysis. ADP, collagen and ristocetin induced a normal aggregation response both before and after dialysis. The Ivy bleeding time remained prolonged after dialysis.

show abstract

“…Researchers have thus concluded [because of resulting low vWF:RCof-to-vWF:Ag ratios or high v~F:Ag-t~-~Vt~F:R~~f ratios (where >1.5 was considered abnormal)] that a significant vWF functional defect is present in patients with renal failure and have explained the observed bleeding tendency in this group of individuals on this basis, despite the high overall ~~'F:Ag present. In other studies, however, data have not supported this conclusion, and similar levels of vWF:Ag and vWF:RCof have been determined (20)(21)(22)(23)(24).. It is tempting to speculate that the differences observed between studies are due merely to differences in the study design and assay test procedures.…”

Section: Normal Reference Ranges For Vwfmentioning

confidence: 79%

“…In renal failure, most studies support a finding of elevated vWF (e.g., Refs. [18][19][20][21][22][23][24]. However, there is dissension regarding the presence or absence of &dquo;functional&dquo; vWF forms.…”

Section: Normal Reference Ranges For Vwfmentioning

confidence: 99%

Laboratory Assessment of von Willebrand Factor: Altered Interpretation of Laboratory Data, and Altered Diagnosis of von Willebrand's Disease

Favaloro

Mehrabani

Koutts

1997

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

Three laboratory assays for von Willebrand Factor (vWF), namely, (i) a standard "antigen" [antiseraenzyme-linked immunosorbent assay (ELISA)-based] (vWF :Ag), (ii) a standard ristocetin-dependent platelet agglutination procedure (vWF:RCof), and (iii) a newly developed ELISA-based functional vWF collagen binding assay (vWF:CBA), were coevaluated. We (a) assessed their ability to detect vWF under different assay conditions and (b) reevaluated normal vWF reference ranges using citrated plasma from >200 normal individuals. The following effective normal reference ranges were derived: vWF-Ag (40-200%), vWF:CBA (50-400%), and vWF:RCof (45-200%). Based on other laboratory data, caution is indicated in the interpretation of "borderline" or "equivocal" test results (e.g., 35-55%), since these may derive from normal individuals or from vWD patients. In addition, our study shows that selection of different assay conditions, different test plasma dilutions, or different test sample processing methods can also lead to differences in the "apparent" levels of detected vWF. For example, using plasma from 100 normal individuals processed as "test samples," we determined that higher sample dilutions tended to provide lower (dilution factor adjusted) assay results in the case of the vWF:Ag and vWF:CBA, and higher assay results in the case of the vWF.RCof, with greater differences noted in test samples containing higher levels of vWF. The explanation for these findings relate to the assay design. Thus, in the diagnostic laboratory, the standard vWF:Ag, vWF:CBA, and vWF:RCof assays procedures are designed to provide calibration curves that are "upward linear" in the (vWD) clinically important region of 0-50% of normal, with a plateau tending at higher vWF levels. Using these standard methodologies, and standard plasma dilutions, high-vWF level test samples will tend to fall on or near the plateau, and results will be unreliable, with a tendency to be exaggerated the higher the vWF. These findings have particular relevance to research studies measuring vWF in patients suffering various clinical conditions (e.g., thrombotic thrombocytopenic purpura, diabetes, renal failure) where higher than normal levels of vWF may be anticipated. In these cases, laboratoryderived vWF levels could be "misrepresented" if the study design did not take into account the need to revise the vWF testing procedure.

show abstract

Bleeding in renal failure: a possible cause.

Cited by 19 publications

References 1 publication

Factor VIII Activity in Chronic Renal Disease

Factor VIII Activity in Chronic Renal Disease

Normalization of fibrin induced platelet aggregation in uraemic patients undergoing haemodialysis

Laboratory Assessment of von Willebrand Factor: Altered Interpretation of Laboratory Data, and Altered Diagnosis of von Willebrand's Disease

Contact Info

Product

Resources

About