ABSTRACT
The hemostatic abnormalities commonly encountered in patients with renal disease can significantly threaten the well-being of the patient and pose difficult management issues for the clinician. In this review, we explore the pathophysiology underlying the bleeding diathesis and hypercoagulability that can occur. Current therapeutic interventions are also discussed.
Subject(s)
Hemorrhagic Disorders/etiology , Kidney Diseases/complications , Blood Coagulation Disorders/etiology , Blood Coagulation Disorders/physiopathology , Blood Coagulation Disorders/therapy , Blood Platelet Disorders/etiology , Blood Platelet Disorders/physiopathology , Blood Platelet Disorders/therapy , Hemorrhagic Disorders/physiopathology , Hemorrhagic Disorders/therapy , Hemostasis , Humans , Kidney Diseases/bloodABSTRACT
The management of hemorrhagic episodes in patients with hemophilia B is in transition as a result of the availability of new products for replacement therapy. Although the basic principles of therapy have not changed, the new highly purified Factor IX concentrates, AlphaNine and Mononine, represent a break-through, as they appear to be safe in terms of viral transmission and thromboembolic side-effects. These products are now widely available, and although expensive, are regarded by some physicians as the preferred therapy for Hemophilia B. Less pure and less expensive Factor IX products, however, are also available and can be used safely in previously treated patients who have already been exposed to the hepatitis viruses.