Hemostatic and fibrinolytic response to nasal desmopressin in hemodialysis patients


Creative Commons License

Ulusoy Ş. , Ovali E., Aydin F., Erem C. , Ozdemir F. , Kaynar K.

MEDICAL PRINCIPLES AND PRACTICE, vol.13, no.6, pp.340-345, 2004 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 13 Issue: 6
  • Publication Date: 2004
  • Doi Number: 10.1159/000080471
  • Title of Journal : MEDICAL PRINCIPLES AND PRACTICE
  • Page Numbers: pp.340-345
  • Keywords: nasal desmopressin, hemodialysis patients, hemostasis, VONWILLEBRAND-FACTOR, UREMIA, MANAGEMENT, PLATELETS, DIALYSIS, BINDING, DEFECT

Abstract

Objective: To evaluate the effect of desmopressin ( DDAVP) on hemostatic parameters during dialysis and in the interval between dialysis sessions. Subjects and 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 mug/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). Conclusion: The findings indicate that DDAVP can be used for patients on dialysis with serious bleeding. Copyright (C) 2004 S. Karger AG, Basel.