title: Safe and effective use of chronic transdermal estradiol for life-threatening uremic bleeding in a patient with coronary artery disease.
abstract: Uremic platelet dysfunction rarely causes significant bleeding in adequately dialyzed patients. When encountered, the management is complicated by a lack of well-supported treatment modalities. Estrogen use in uremic platelet dysfunction has been described, but enthusiasm for the treatment has been dampened by the risk of thrombotic events in vasculopathic dialysis patients. We present a patient on long-term peritoneal dialysis with coronary disease who developed recurrent life-threatening bleeding episodes secondary to uremia, where treatment with transdermal estrogen was used safely and effectively for a 24-month period.
authors.affiliation: Department of Internal Medicine, Rochester General Hospital, University of Rochester School of Medicine and Dentistry, N.Y., USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Bali
authors.affiliation: Department of Internal Medicine, Rochester General Hospital, University of Rochester School of Medicine and Dentistry, N.Y., USA ; Nephrology Division, Department of Medicine, University of Rochester School of Medicine and Dentistry, N.Y., USA.
authors.forename: John Kevin
authors.initials: JK
authors.lastname: Hix
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, N.Y., USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kouides
keywords: Bleeding; Chronic kidney disease; Transdermal estradiol; Uremic platelets