title: A successful treatment of life-threatening bleeding from polycystic kidneys with antifibrinolytic agent tranexamic acid.
abstract: We describe a successful treatment of a severe, persistent bleeding from both kidneys in a patient with autosomal dominant polycystic kidney disease (ADPKD) with tranexamic acid (TXA), a potent antifibrinolytic agent. The bleeding could not be controlled by intensive conservative treatment, it became life-threatening and urgent bilateral nephrectomy was intended. Since local and systemic hyperfibrinolysis play a role in bleeding in ADPKD patients, we tried TXA treatment. In fact, the massive bleeding promptly stopped, and haematuria gradually ceased. Removal of both kidneys was prevented. After 5 days both ureters became obstructed by blood clots, but placing J-catheters in each pyelon successfully solved this complication. Our case shows that it is reasonable to try antifibrinolytic treatment with TXA in such devastating uncontrolled bleeding.
authors.affiliation: Department for Nephrology and Dialysis, General Hospital, Slovenj Gradec, Slovenia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Vujkovac
authors.forename: Miso
authors.initials: M
authors.lastname: Sabovic
mesh_terms: D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006417:Hematuria / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid