Factor VIII Activity in Chronic Renal Disease

Wegmüller, E; Grüninger, U.; Furlan, Miha; Beck, Eduarda; Hodler, J; Reubi, F

doi:10.1159/000182161

Cited by 20 publications

(10 citation statements)

References 7 publications

(9 reference statements)

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“…Our studies confirm the finding of others [20,25,29,30] that patients with chronic renal failure have normal or high plasma levels of factor VIII activities. Although DDAVP infusion tended to further elevate these levels, only FVIIIRCOF was significantly elevated.…”

Section: Discussionsupporting

confidence: 92%

“…Were this the case, the logical therapeutic manoeuvre would be cryoprecipitate or DDAVP infusion. However, this observation has not been confirmed by the majority of investigators, and it would now appear that the activity of factor VIII von Willebrand's factor is normal or even elevated in uraemic patients [20,25,29,30]. Moreover, normal factor VIII related protein is immunologically detectable in the vascular intima of patients with chronic renal failure who have prolonged bleeding times [23].…”

Section: Discussionmentioning

confidence: 98%

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Effect of 1-Deamino-8-D-Arginine Vasopressin on the Prolonged Bleeding Time in Chronic Renal Failure

Watson

Keogh²

1982

Nephron

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The prolonged bleeding times of 12 patients with chronic renal failure were significantly shortened at 1 and 2 h after an infusion of 0.4 µg/kg 1-deamino-8-D-arginine vasopressin (DDAVP). In 5 of these patients, the bleeding times 24 h after infusion had returned to approximate baseline values, suggesting that the effect of DDAVP is a temporary one. The levels of factor VIII coagulant activity, factor VIII related antigen activity, and factor VIII ristocetin cofactor activity were all normal or elevated prior to infusion, and a tendency to further elevation, although significant only for the factor VIII ristocetin cofactor activity, was observed after infusion of DDAVP. The latter observation suggests that the effect of DDAVP infusion on the bleeding time is unrelated to alteration of factor VIII activities.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Effect of 1-Deamino-8-D-Arginine Vasopressin on the Prolonged Bleeding Time in Chronic Renal Failure

Watson

Keogh²

1982

Nephron

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“…Increasing factor VIlI:c has obviously no great importance to the hemo stasis. Previously it has been reported that factor VIILc acts as an acute-phase reactant in uremic patients [18],…”

Section: Discussionmentioning

confidence: 99%

Influence of Recombinant Human Erythropoietin on Platelet Function and Coagulation Factors

1992

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Reports on the effect of recombinant human erythropoietin (r-HUEPO) on the platelet activity are conflicting. In the present study platelet function and coagulation factors were investigated in 20 patients with end-stage renal failure on maintenance hemodialysis. The patients were randomized into two groups and, in a crossover design, investigated during intravenous and subcutaneous administration of rHUEPO. The two groups started with a different administration form (intravenously in group 1 and subcutaneously in group 2), and each mode of treatment was given for 3 months. At entrance into the study the platelets were hyperaggregable to exogenous stimulation with collagen (COL) in both groups. Group 1 developed increasing platelet sensitivity to adenosine diphosphate (ADP; 0.01 < p < 0.025) during intravenous treatment. Concomitantly, three episodes of arteriovenous fistula thrombosis occurred. In group 2 one event of fistula thrombosis occurred despite there being no change in platelet reactivity to ADP. After 3 months on r-HUEPO, the platelet reactivity to ADP decreased significantly in both groups, but also the reactivity to COL declined significantly: 0.01 < p < 0.025 (group 1) versus 0.001 < p < 0.005 (group 2). The platelet reactivity to ristocetin remained unchanged in group 1 but decreased significantly in group 2. In group 1 fibrinogen was increased significantly (0.001 < p < 0.005) at the time of the clotting events. The factor VIIL·coagulant activity increased, but antithrombin III, activated factors X and XIII, activated protein C, activated thromboplastin time, and partial prothrombin time remained unchanged. Furthermore, 4 patients in group 1 and 2 patients in group 2 required an increased dose of heparin after 2-3 months of investigation. Thus, r-HUEPO seemed to influence platelet function. Enhanced activity was observed during intravenous administration. Eventually, platelet reactivity to ex vivo stimulation decreased in both groups. Thus, intravascular hemostatic activation seemed to occur following r-HUEPO administration. An increase in hematocrit is probably of importance, but according to the present data, transient platelet activation may also be a contributory factor.

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“…Although factor VIII-von Willebrand's levels appear to be normal or even elevated in the presence of renal insufficiency [8][9][10], an increase in the circulating levels of larger mul timeric forms of this factor following DDAVP infusion has recently been noted [4], Thus, it is tempting to spec ulate that DDAVP exerted its beneficial effect on the pro longed bleeding time and clinical hemorrhage in the cases presented via alteration of factor VIII-von Willebrand's factor activity. Further support of this hypothesis and the possibility that factor VIII-von Willebrand's factor activ ity may be at least partly responsible for the hemostatic defect of uremia is provided by the report of Janson et al [11].…”

Section: Discussionmentioning

confidence: 99%

1-Deamino-8-<i>D</i>-Arginine Vasopressin as a Therapy for the Bleeding Diathesis of Renal Failure

Watson¹,

Keogh²

1984

Am J Nephrol

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Factor VIII Activity in Chronic Renal Disease

Cited by 20 publications

References 7 publications

Effect of 1-Deamino-8-D-Arginine Vasopressin on the Prolonged Bleeding Time in Chronic Renal Failure

Effect of 1-Deamino-8-D-Arginine Vasopressin on the Prolonged Bleeding Time in Chronic Renal Failure

Influence of Recombinant Human Erythropoietin on Platelet Function and Coagulation Factors

1-Deamino-8-<i>D</i>-Arginine Vasopressin as a Therapy for the Bleeding Diathesis of Renal Failure

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