Reduced fibrinolytic capacity and its restoration by plasminogen substitution in acute renal failure.
A common finding in acute renal failure, particularly if it is caused by septic shock, consists of fibrin deposits in the intrarenal blood vessels. In a study of fibrinolytic parameters in 82 patients with severe bacterial infections, a significant negative correlation between plasminogen plasma concentration and serum creatinine was found. On admission the plasminogen levels were lower than the alpha 2-antiplasmin concentrations, which means a reduction of the fibrinolytic capacity due to a preponderance of the inhibitor. Preliminary experience with a replacement therapy is here reported. In 9 patients with an acute renal failure due to septicaemia or other serious diseases with shock, a substitution with fresh frozen plasma and antithrombin III concentrate was carried out in order to stop disseminated coagulation. A considerable increase of urine excretion was observed in 5 of these patients in close connection with the additional administration of a plasminogen concentrate.
Seitz
R
R
Department of Haematology, University of Marburg, F.R. Germany.
Karges
H E
HE
Wolf
M
M
Egbring
R
R
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D003401:Creatine / Q000097:blood; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010958:Plasminogen / Q000494:pharmacology / Q000627:therapeutic use*; D000979:alpha-2-Antiplasmin / Q000032:analysis
D000979:alpha-2-Antiplasmin; D010958:Plasminogen; D005341:Fibrinolysin; D003401:Creatine