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Pomen ocene hemostaze z zapiralnim časom in pomanjkanja železa z deležem hipokromnih eritrocitov ter povezanost obeh pri kroničnih dializnih bolnikih : doktorsko delo
Preložnik Zupan, Irena, medicina
Introduction and aim: Bleeding tendency is a common problem in dialysis patients and is an important cause of both morbidity and mortality. The main characteristic of haemostasis impairment is ...acquired platelet dysfunction. It has been shown that anaemia by itself contributes to primary haemostasis impairment. Some data also show that fibrinolysis plays a significant role in the defect of primary haemostasis in uraemia. In four consecutive studies we explored thereforeČ (1) the utility of a novel in vitro closure time test for assessment of primary haemostasis impairment in dialysis patientsč (2) the precise relation between the degree of anaemia and the degree of haemostasis impairment with the optimal level of hematocrit above which anaemia no longer disturbs haemostasisč (3) possible associations between haemostasis impairmentand iron deficiency, and (4) if inhibition of fibrinolysis may improve platelet dysfunction in uremia. Patients and methods: Sixty-three chronic dialysis patients were included in the first three studies, with 30 age and sex-matched, healthy controls. Patients were from two dialysis centresČ The University Medical Centre Ljubljana and Slovenj Gradec General Hospital. In the first three studies general laboratory parameters, primary haemostasis tests and iron deficiency parameters were measured immediately before the first dialysis session in the week. The fourth study group comprised 22 patients who were treated for three months with tranexamic acid, a potent anti-fibrinolytic agent. Haemostasis impairment was detected by in vitro closure time testsč (functional) iron deficiency was measured by reticulocyte haemoglohin content (CHr) and the percentage of hypochromic red cells (HRC). ResultsČ In the first study we found that in vitro closure time is more sensitive and specific than the skin bleeding time or platelet aggregation. (Abstract truncated at 2000 characters).
Type of material - dissertation
Publication and manufacture - Ljubljana : [I. Preložnik Zupan], 2005
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