Hemostatic and fibrinolytic response to nasal desmopressin in hemodialysis patients.
OBJECTIVE
To evaluate the effect of desmopressin (DDAVP) on hemostatic parameters during dialysis and in the interval between dialysis sessions.


METHODS
Fifteen patients dialyzed twice weekly at least for 1 year and 15 healthy volunteers serving as a control group were enrolled in the study. Bleeding time, platelet count, prothrombin time, activated partial thromboplastin time, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1), euglobulin clot lysis time, protein C, protein S, fibrinogen, D-dimer, factor V, VII, VIII, IX, X and von Willebrand factor (VWF) values were studied at the beginning, at 2 and 4 h of dialysis with and without administration of DDAVP at a dose level of 2 microg/kg intranasally.


RESULTS
After dialysis, bleeding time shortened, PAI-1 and fibrinogen levels were lower, while VWF and D-dimer levels were higher. After DDAVP administration, bleeding time, PAI-1 levels were significantly lower (p <0.01), while tPA, factor VIII and VWF levels increased significantly (p <0.001).


CONCLUSIONS
The findings indicate that DDAVP can be used for patients on dialysis with serious bleeding.
Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. kkaynar@yahoo.com
Sukru
S
Ulusoy
Ercument
E
Ovali
Fazil
F
Aydin
Cihangir
C
Erem
Feyyaz
F
Ozdemir
Kubra
K
Kaynar
D000281:Administration, Intranasal; D001760:Bleeding Time; D001779:Blood Coagulation Factors / Q000032:analysis / Q000187:drug effects*; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology*; D005260:Female; D006490:Hemostatics / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D006435:Renal Dialysis
D001779:Blood Coagulation Factors; D006490:Hemostatics; D003894:Deamino Arginine Vasopressin