Blood Coagulation Disturbances During Oliguria And Polyuria Of Acute Renal Failure In Man

1981 ◽  
Author(s):  
J Schrader ◽  
H Köstering ◽  
H Kaiser ◽  
P Kramer ◽  
F Scheler
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Blood Coagulation ◽  
Daily Basis ◽  
Coagulation System ◽  
Factor V ◽  
Thrombin Time ◽  
Complex Activity ◽  
Ischemic Renal Failure ◽  
Postrenal Failure

The blood coagulation system makes a significant contribution to renal damage in many disease processes. Intrarenal coagulation appears to occur in a wide variety of diseases as a primary or secondary event. As there is evidence that intraglomerular coagulation is a significant factor in the development and maintenance of oliguria in acute ischemic renal failure, blood coagulation investigations were performed in 20 patients with acute renal failure of varied etiology. The investigations were done on a daily basis from the onset of oliguria (urine flow <20 ml/h)until serum creatinine declined to less than 2,0 mg%. Thus, we were able to detect changes in blood coagulation during oliguria and polyuria. We found an enhanced thrombin generation in both oliguria and polyria. Fibrin monomer complexes were significantly increased in both states, but more predominantly in polyuria. Factor VIII and alpha-1 antitrypsin activities were also elevated. PTT and r- and k-time in TEG were shortened more in polyuria than in oliguria, whereas fibrinogen was elevated more in oliguria than in polyuria. Factor XIII activity and prothrombin complex activity (Quick’s test) were lowered in both states, the lowest values of the former being found in polyuria, the lowest values of the latter in oliguria with a normalizing tendency in the following days. Fibrinolytic activity was also decreased. No significant changes were found in plasminogen, antithrombin III, alpha-2 macroglobulin, factor V and thrombin time. In summary, we found a hypercoagulability in these patients with acute renal failure, which was more predominant during polyuria and which correlated with the tendency to thrombosis and to shorter indwelling periods of i.v. catheters in this state. Consequently, the changes in blood coagulation of 3 patients with acute postrenal failure were not as significant as those found in the other patients. The treatment with anticoagulants in patients with acute renal failure will be discussed.

scholarly journals Snakebites by Bothrops spp in children in Campinas, São Paulo, Brazil

2001 ◽  
Vol 43 (6) ◽  
pp. 329-333 ◽  
Author(s):  
Fábio BUCARETCHI ◽  
Sílvia Regina Fontoura HERRERA ◽  
Stephen HYSLOP ◽  
Emílio Carlos Elias BARACAT ◽  
Ronan José VIEIRA
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Compartment Syndrome ◽  
Blood Coagulation ◽  
Sao Paulo ◽  
Blood Coagulation Disorders ◽  
Local Infection ◽  
Coagulation Disorders ◽  
H2 Antagonists ◽  
Clinical Complications

From January, 1984 to March, 1999, 73 children under 15 y old (ages 1-14 y, median 9 y) were admitted after being bitten by snakes of the genus Bothrops. Twenty-six percent of the children were classified as mild envenoming, 50.7% as moderate envenoming and 20.6% as severe envenoming. Two patients (2.7%) showed no signs of envenoming. Most of the patients presented local manifestations, mainly edema (94.5%), pain (94.5%) ecchymosis (73.9%) and blisters (11%). Local and/or systemic bleeding was observed in 28.8% of the patients. Before antivenom (AV) administration, blood coagulation disorders were observed in 60.7% (incoagulable blood in 39.3%) of the 56 children that received AV only in our hospital. AV early reactions, most of which were considered mild, were observed in 44.6% of these cases (in 15/30 patients not pretreated and in 10/26 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). The main clinical complications observed were local infection (15.1%), compartment syndrome (4.1%), gangrene (1.4%) and acute renal failure (1.4%). No deaths were recorded. There were no significant differences with regard to severity of envenoming versus the frequency of blood coagulation disorders among the three categories of envenoming (p = 0.75) or in the frequency of patients with AV early reactions between the groups that were and were not pretreated (p = 0.55). The frequency of local infection was significantly greater in severe cases (p < 0.001). Patients admitted more than 6 h after the bite had a higher risk of developing severe envenoming (p = 0.04).

Prerenal and Intrinsic Renal Failure

1994 ◽  
Vol 15 (7) ◽  
pp. 253-292
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Structural Changes ◽  
Urine Specific Gravity ◽  
Laboratory Studies ◽  
Diagnostic Categories ◽  
Structural Abnormalities ◽  
Postrenal Failure ◽  
Intact Kidney

Acute renal failure has been divided into three diagnostic categories: prerenal, intrarenal (also called organic and intrinsic), and postrenal failure. Prerenal failures are responses of a structurally intact kidney to extrarenal processes. In most instances, the kidneys recover rapidly as soon as the course is reversed. Intrinsic renal failure is caused by structural changes within the kidneys, and postrenal failure is due to structural abnormalities in the ureters, bladder, or urethra. Prerenal failure usually is due to decreased effective blood volume or heart failure from such conditions as dehydration or shock. Laboratory studies demonstrate hemoconcentrates, few abnormalities of the urine, preserved tubular integrity, high urine-specific gravity, and low urinary sodium.

Effective inhibition of experimental metastasis and prolongation of survival in mice by a potent factor Xa-specific synthetic serine protease inhibitor with weak anticoagulant activity

2005 ◽  
Vol 94 (11) ◽  
pp. 1084-1093 ◽  
Author(s):  
Ingo Banke ◽  
Matthias Arlt ◽  
Markus Mueller ◽  
Stefan Sperl ◽  
Axel Stemberger ◽  
...  
Keyword(s):  
Serine Protease ◽  
Blood Coagulation ◽  
Anticancer Agents ◽  
Cell Lymphoma ◽  
Malignant Tumors ◽  
Anticoagulant Activity ◽  
Factor Xa ◽  
Metastatic Potential ◽  
Coagulation System ◽  
Complex Activity

SummaryClinical and experimental evidence suggests that the blood coagulation system is involved in the dissemination of malignant tumors. Consequently, anticoagulant agents have been tested as metastasis suppressors in experimental models. Recently, we have found a close correlation between factor Xa (FXa)-specificity of a series of synthetic serine protease inhibitors and their anti-metastatic potential in a murineT-cell lymphoma metastasis model. Interference of such inhibitors with blood-coagulation may represent a major experimental and clinical obstacle. Here, we test anti-metastatic effects of a recently developed, highly specific 3-amidinophenylalanine-type FXa inhibitor, WX-FX4, with weaker anticoagulant activity when compared to well-established FXa inhibitors, such as DX-9065a, as measured by the activated partial thromboplastin time, prothrombin time, prothrombinase complex activity, and coagulation time. Treatment of mice with WX-FX4 (1.5 mg/kg twice daily) led to significant reduction of experimental liver metastasis of a syngeneic T-cell lymphoma in DBA/2 mice (> 90%), and of experimental lung metastasis of a human fibrosarcoma in CD1 nu/nu mice (> 60%). Due to its relatively low anticoagulant activity, daily treatment over 100 days was possible, leading to significant survival benefits without inducing bleeding anomalities. FXa-inhibitors with highly efficient anti-metastatic potential without coagulationrelated side effects may represent important new tools as anticancer agents.

scholarly journals The effects of fructose diphosphate on routine coagulation tests in vitro

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Tongqing Chen ◽  
Duan Chen ◽  
Lu Chen ◽  
Zhengxu Chen ◽  
Baolong Wang ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Blood Coagulation ◽  
Detection System ◽  
Coagulation System ◽  
Thrombin Time ◽  
Aggregation Rate ◽  
Coagulation Testing ◽  
Coagulation Tests ◽  
Routine Coagulation

AbstractTo evaluate the effects of fructose diphosphate (FDP) on routine coagulation tests in vitro, we added FDP into the mixed normal plasma to obtain the final concentration of 0, 1, 2, 3, 4, 5, 6, 10, 15, 20, 25, 30 and 35 mg/mL of drug. Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen (FBG) and thrombin time (TT) of samples were analyzed with blood coagulation analyzers from four different manufacturers(Sysmex, Stago, SEKISUI and Werfen) and their corresponding reagents, respectively. Before the experiment, we also observed whether there were significant differences in coagulation test results of different lots of reagents produced by each manufacturer. At the same time as the four routine clotting tests, the Sysmex blood coagulation analyzer and its proprietary analysis software were used to detect the change of maximum platelet aggregation rate in platelet-rich plasma after adding FDP (0, 1, 2, 3, 4, 5 and 6 mg/mL). The results of PT, aPTT and TT showed a FDP (0–35 mg/mL) concentration-dependent increase and a FBG concentration-dependent decrease. The degree of change (increase or decrease) varied depending on the assay system, with PT and aPTT being more affected by the Sysmex blood coagulation testing instrument reagent system and less affected by CEKISUI, TT less affected by CEKISUI and more affected by Stago, and FBG less affected by Stago and more affected by Sysmex. The results of PT, aPTT and TT were statistically positively correlated with their FDP concentrations, while FBG was negatively correlated. The correlation coefficients between FDP and the coagulation testing systems of Sysmex, Stago, Werfen and SEKISUI were 0.975, 0.988, 0.967, 0.986 for PT, and 0.993, 0.989, 0.990 and 0.962 for aPTT, 0.994, 0.960, 0.977 and 0.982 for TT, − 0.990, − 0.983, − 0.989 and − 0.954 for FBG, respectively. Different concentrations of FDP (0, 1, 2, 3, 4, 5 and 6 mg/mL) had different effects on the maximum aggregation rate of platelet induced by the agonists of adenosine diphosphate (ADP, 5 µmol/L), arachidonic acid (Ara, 1 mmol/L), collagen (Col, 2.5 µg/mL) and epinephrine (Epi,10 µmol/L), but the overall downward trend was consistent, that is, with the increase of FDP concentration, the platelet aggregation rate decreased significantly. Our experimental study demonstrated a possible effect of FDP on the assays of coagulation and Platelet aggregation, which may arise because the drug interferes with the coagulation and platelet aggregation detection system, or it may affect our in vivo coagulation system and Platelet aggregation function, the real mechanism of which remains to be further verified and studied.

Acute Renal Failure in Rats

1989 ◽  
Vol 30 (3) ◽  
pp. 321-326 ◽  
Author(s):  
C. Cederholm ◽  
T. Almén ◽  
D. Bergqvist ◽  
K. Golman ◽  
R. Takolander
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Contrast Media ◽  
Intravenous Injection ◽  
Renal Injury ◽  
Arterial Occlusion ◽  
Percentage Increase ◽  
Serum Urea ◽  
Ischemic Renal Failure ◽  
The Media

It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40 per cent (20–130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130 per cent (70–350) after metrizoate, by 220 per cent (50–380) after ioxaglate, by 290 per cent (60–420) after iopamidol and by 160 per cent (50–330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure.

The blood coagulation system of rats under the influence of laser radiation in different time parameters

2019 ◽  
Vol 11 (1) ◽  
pp. 19-26
Author(s):  
Oksana Ketsa ◽  
Mykhailo Marchenko ◽  
Nadiia Bodnarjuk
Keyword(s):  
Prothrombin Time ◽  
Laser Irradiation ◽  
Blood Coagulation ◽  
Laser Diode ◽  
Coagulation System ◽  
Simultaneous Increase ◽  
Thrombin Time ◽  
Blood Coagulation System ◽  
Group I ◽  
Time Parameters

The influence of different terms of laser irradiation on vascular-platelet and coagulation units of blood coagulation system is investigated. The rats were irradiated with a laser diode in the red spectrum (650 nm) with a power of 50 mW. Rats were divided into two groups: group I - rats, which were irradiated daily for 2 minutes; group II - rats, which were irradiated daily for 4 minutes. Euthanasia of animals was performed on the 7th and 14th days after the onset of irradiation. For the study of the blood coagulation system of rats used biochemical coagulogram with the analysis of the following indicators - the content of fibrinogen, thrombin and prothrombin time, activated partial thromboplastin time (APTT), platelet count. The content of lymphocytes and erythrocyte sedimentation rate were determined also. In the work used blood plasma with sodium citrate. It has been found that daily four-minute laser irradiation in the abdominal area for two weeks leads to a decrease in the concentration of factor I blood clotting (fibrinogen) and an increase in thrombin time. At the same time, prolongation of prothrombin time and APTT was detected, indicating a deficiency of other factors of blood coagulation - II, V, VII-XII, and the presence of anticoagulant status, which may be associated with inhibition of the internal pathway of clotting. Thrombocytopenia is probably caused by the increased destruction of platelets or their insufficient formation as a result of dysfunction of hematopoietic organs. The two-minute effect of laser irradiation does not affect the clinical and biochemical parameters of the blood coagulation system of rats after a weekly daily action of the laser diode. Two weeks irradiation is accompanied by processes of hypocoagulation, as evidenced by a decrease in fibrinogen levels, platelet counts, and a simultaneous increase in APTT, thrombin and prothrombin time.

Heme oxygenase-1 induction improves ischemic renal failure: role of nitric oxide and peroxynitrite

2007 ◽  
Vol 293 (6) ◽  
pp. H3542-H3549 ◽  
Author(s):  
Miguel G. Salom ◽  
Susana Nieto Cerón ◽  
Francisca Rodriguez ◽  
Bernardo Lopez ◽  
Isabel Hernández ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Heme Oxygenase ◽  
Heme Oxygenase 1 ◽  
Beneficial Effects ◽  
Medullary Blood Flow ◽  
Ischemic Renal Failure ◽  
Oxide Synthase

The present study evaluated the effects of heme oxygenase-1 (HO-1) induction on the changes in renal outer medullary nitric oxide (NO) and peroxynitrite levels during 45-min renal ischemia and 30-min reperfusion in anesthetized rats. Glomerular filtration rate (GFR), outer medullary blood flow (OMBF), HO and nitric oxide synthase (NOS) isoform expression, and renal low-molecular-weight thiols (–SH) were also determined. During ischemia significant increases in NO levels and peroxynitrite signal were observed (from 832.1 ± 129.3 to 2,928.6 ± 502.0 nM and from 3.8 ± 0.7 to 9.0 ± 1.6 nA before and during ischemia, respectively) that dropped to preischemic levels during reperfusion. OMBF and –SH significantly decreased after 30 min of reperfusion. Twenty-four hours later, an acute renal failure was observed (GFR 923.0 ± 66.0 and 253.6 ± 55.3 μl·min−1·g kidney wt−1 in sham-operated and ischemic kidneys, respectively; P < 0.05). The induction of HO-1 (CoCl2 60 mg/kg sc, 24 h before ischemia) decreased basal NO concentration (99.7 ± 41.0 nM), although endothelial and neuronal NOS expression were slightly increased. CoCl2 administration also blunted the ischemic increase in NO and peroxynitrite (maximum values of 1,315.6 ± 445.6 nM and 6.3 ± 0.5 nA, respectively; P < 0.05), preserving postischemic OMBF and GFR (686.4 ± 45.2 μl·min−1·g kidney wt−1). These beneficial effects of CoCl2 on ischemic acute renal failure seem to be due to HO-1 induction, because they were abolished by stannous mesoporphyrin, a HO inhibitor. In conclusion, HO-1 induction has a protective effect on ischemic renal failure that seems to be partially mediated by decreasing the excessive production of NO with the subsequent reduction in peroxynitrite formation observed during ischemia.

Serious Renal Disease in Egypt

1995 ◽  
Vol 18 (5) ◽  
pp. 254-260 ◽  
Author(s):  
M.A. Essamie ◽  
A. Soliman ◽  
T.M.S. Fayad ◽  
S. Barsoum ◽  
C.M. Kjellstrand
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Disease ◽  
Diabetic Patients ◽  
Diabetes Mellitus Type Ii ◽  
End Stage Renal Failure ◽  
Common Diagnosis ◽  
Postrenal Failure ◽  
End Stage ◽  
The University

We studied serious renal disease in Egypt by registering all 155 patients coming to the nephrology service at the University of Cairo during a period of 62 days in 1993. The patients presented with severe uremic symptoms. Admission creatinine and urea levels were high, 804 μmol/l and 64 mmol/l. Fifteen percent of the patients died; 115 underwent dialysis. Sixty patients presented with chronic renal failure; 53 with acute renal failure, but 24 of these were later found to have end-stage renal failure. Of 29 patients with true acute renal failure, 11 (38%) had pre-renal failure and 7 (24%) postrenal failure. Twenty-one patients were followed up after transplantation and chronic dialysis, another 17 had nephrotic syndrome, 3 hypertension, and one had asymptomatic urinary abnormalities. The most common specific etiology for chronic end-stage renal failure was diabetes mellitus type II in the older patients; second most common was Schistosoma in the younger ones. Most diabetic patients came from the city. All but one Schistosoma patient came from rural Egypt. In the 22 patients who underwent renal biopsy the most common diagnosis was mesangio capillary glomerulonephritis. The prevalence of acute renal failure, particularly iatrogenic-toxic, is increasing

Comparative analysis of the results of non-activated thromboelastometry and thromboelastography of venous blood in pregnant women in health and disease

2021 ◽  
Author(s):  
Л.А. Пестряева ◽  
С.В. Кинжалова ◽  
Н.В. Путилова ◽  
С.В. Борисова
Keyword(s):  
Comparative Analysis ◽  
Pregnant Women ◽  
Blood Coagulation ◽  
Main Group ◽  
Coagulation System ◽  
Control Group ◽  
Blood Coagulation Disorders ◽  
Fibrinogen Concentration ◽  
Reference Ranges ◽  
Thrombin Time

Цель исследования: сравнительный анализ неактивированной тромбоэластографии (ТЭГ) и тромбоэластометрии (ТЭМ) в диагностике нарушений свертывающей системы крови при беременности. Материалы и методы. Обследованы 2 группы женщин в III триместре беременности: 44 женщины с привычным невынашиванием беременности в анамнезе (основная группа) и 35 условно здоровых беременных (контрольная группа). Пациентки основной группы получали профилактику тромботических осложнений низкомолекулярными гепаринами (НМГ). Выполнено стандартное исследование свертывающей системы крови: подсчет тромбоцитов, определение концентрации фибриногена, протромбинового времени (ПТ) по Квику, активированного частичного тромбопластинового времени (АЧТВ), тромбинового времени (ТВ), неактивированная ТЭГ и ТЭМ. Результаты. Значимых различий в значениях фибриногена, АЧТВ, ПТ между группами выявлено не было. В обеих группах при ТЭГ/ТЭМ исследовании установлено укорочение интервалов времени свертывания и времени образования сгустка, увеличение плотности сгустка, что соответствует протромботическим изменениям системы гемостаза при беременности. Определены значения показателей неактивированной ТЭГ/ТЭМ в III триместре физиологически протекающей беременности. Заключение. Методы неактивированной ТЭГ и ТЭМ имеют высокую информативность в диагностике нарушений системы гемостаза и могут быть использованы для контроля состояния свертывающей системы крови при беременности наряду с активированными стандартизованными тестами. Objectives: to conduct a comparative analysis of non-activated thromboelastography (TEG) and thromboelastometry (TEM) in the diagnosis of blood coagulation disorders during pregnancy. Patients/Methods. We examined 2 groups of women in III trimester of pregnancy: 44 women with a history of habitual miscarriage (the main group) and 35 relatively healthy pregnant women (the control group). Patients of the main group received prophylaxis of thrombotic complications with low molecular weight heparins (LMWH). A standard study of the blood coagulation system with platelet count, determination of fibrinogen concentration, prothrombin time (PT) by Quick, activated partial thromboplastin time (APTT), thrombin time (TT), non-activated thromboelastography (TЕG) and thromboelastometry (TEM) was performed. Results. There were no signifi cant differences in fi brinogen level, APTT, PT between the groups. In both groups, TEG/TEM study found shortening of the clotting time intervals and clot formation time, an increase in clot density, which corresponds to hemostasis prothrombotic changes during pregnancy. Reference ranges of nonactivated TEG/TEM parameters in III trimester of physiological pregnancy were determined. Conclusions. Methods of non-activated TEG/TEM are highly informative in the diagnosis of hemostasis disorders and can be used, together with activated standardized tests, to monitor blood coagulation during pregnancy.

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