Anticoagulation therapy in acute renal failure extracorporeal treated patients.
In extracorporeal techniques, as used for Acute Renal Failure (ARF) treatments, blood is constantly exposed to foreign surfaces. These foreign surfaces include the catheter(s), blood tubings, the dialyser membrane and all artificial materials used for such techniques in general. Blood begins to clot as soon as it strikes a foreign surface. The foreign surface initiates the clotting process. The extracorporeal circuit is prone to clotting during acute treatments unless some form of anticoagulation is employed. On the other hand, this specific group of patients is often at increased risk of bleeding (cfr. Post-operative patients and post-renal-transplant patients, patients with Multiple Organ Failure (MOF) often including liver disturbances). It should be kept in mind that patients with renal failure have a defect in platelet function resulting in altered platelet-vessel wall interaction. Over time, as the extracorporeal treatment progresses, the platelets become more adhesive or sticky. The blood becomes more likely to clot. Performing effective therapy with low bleeding risk in ARF patients is a challenge requiring knowledge, skills and experience.
De Vos
J Y
JY
Haemodialysis Unit, Ronse, Belgium. 106111.2261@compuserve.com
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000378:metabolism / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D001835:Body Weight; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D006494:Heparin Antagonists / Q000627:therapeutic use; D006801:Humans; D011479:Protamines / Q000627:therapeutic use; D006435:Renal Dialysis / Q000451:nursing; D012307:Risk Factors
D000925:Anticoagulants; D006494:Heparin Antagonists; D011479:Protamines