Thromb Haemost 1971; 26(02): 332-340
DOI: 10.1055/s-0038-1653681
Originalarbeiten – Original Articles – Travaux Originaux
Schattauer GmbH

Disseminated Intravascular Coagulation and Acute Renal Failure

I Crîsnic
1   Medical Clinic I (Head: Prof. St. Hărăgus), Cluj, Romania
,
M Cucuianu
1   Medical Clinic I (Head: Prof. St. Hărăgus), Cluj, Romania
,
M Manasia
1   Medical Clinic I (Head: Prof. St. Hărăgus), Cluj, Romania
,
G Uza
1   Medical Clinic I (Head: Prof. St. Hărăgus), Cluj, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
28 June 2018 (online)

Summary

Starting from a hypothesis according to which disseminated intravascular coagulation might be an intermediary mechanism in the production of acute renal failure, investigations were made in 94 cases of anuria of different etiology, in order to detect signs of a consumption coagulopathy. After an average lapse of time of 48 h since the onset of anuria, the most frequently encountered hemostatic defect was a decreased platelet adhesiveness. In vitro experiments and clinical observations suggest that in the early stage of acute renal failure caused by a septic abortion, deficient platelet adhesiveness is due, mainly to platelet damage caused by intravascular coagulation or by bacterial toxins and not by the retention of metabolites. Euglobulin lysis time was prolonged, but a significant decrease of the plasminogen level indicates that an activation of fibrinolysis might have occured in the evolution of the process.

 
  • References

  • 1 Aljkjaersig N, Fletcher A. P, Sherry S. The mechanism of clot dissolution by plasmin. J. clin. Invest 38: 1086 1959;
  • 2 Amerio A, De Benedictis G, Leondeff J, Mastrangelo F, Caratelli P. La nefrepatia da apiolo. Minerva nefrologica 15: 49 1968;
  • 3 Bluemle L. W, Webster B. D, Elkington J. R. Acute tubular necrosis. Analysis of 100 cases with respect to mortality complications and treatment with and without dialysis. Arch, intern. Med 104: 180 1959;
  • 4 Castaldi P. A, Rozemberg M. C, Stewart I. H. The bleeding disorder of uremia. A qualitative platelet defect. Lancet II: 66 1966;
  • 5 Cucucianu M. Betalipoproteins and euglobulin lysis time. Thrombos. Diathes. haemorrh. (Stuttg) 16: 687 1966;
  • 6 Cucuianu M, Papilian V. V, Bareliuc N, Crisnic I. Platelet adhesiveness and euglobulinlysis time in dogs given repeated infusion of sodium plamitate. Thrombos. Diathes. haemorrh. (Stuttg) 22: 164 1969;
  • 7 De la Huerga I, Yesinick G, Popper H. Colorimetric method for the determination of serum Cholinesterase. Amer. J. clin. Path 22: 1126 1952;
  • 8 Donner L, Neuwirtowa R. The hemostatic defect of acute and chronic uremia. Thrombos. Diathes. haemorrh. (Stuttg) 05: 319 1961;
  • 9 Hardaway R. M, MC Kay D. G, Williams J. H. Lower nephron nephrosis (Ischemuric nephrosis). Amer. J. Surg 87: 41 1954;
  • 10 Hardaway R. M. Syndromes of disseminated intravascular coagulation. Ed. Thomas C. Springfield; Ill 1966.
  • 11 Hesse V. E, Mink I. B, Murphy G. P, Moore R. H, Ambrus I. L. Hemodialysis and hemostatic function. N.Y. St. J. Med 70: 1851 1970;
  • 12 Holdrinet A, Ewals M, Heanen C. A simple test for measuring platelet aggregation. Results in von Willebrand disease and uremia. Thrombos. Diathes. haemorrh. (Stuttg) 22: 174 1969;
  • 13 Horowitz H. I, Cohen B. D, Martinez P, Papayoanou M. F. Defective ADP induced platelet factor III activation in uraemia. Blood 30: 331 1967;
  • 14 Kendall A. G, Lowenstein L, Morgen R. O. The hemorrhagic diathesis in renal disease with special reference to acute uremia. Canad. med. Ass. J 85: 405 1961;
  • 15 Larrain C, Adelson E. The hemostatic defect of uremia. I. Clinical investigations of three patients with acute posttraumatic renal insufficiency. Blood 11: 1059 1956;
  • 16 Lasch H. G, Heene D. L. Diagnosis of intravascular coagulation and fibrinolysis. In: Platelets their role in hemostasis and thrombosis. 351 F.K. Schattauer; Stuttgart: 1967
  • 17 Loewenstein L, Balew D. H. Fatal acute hemolytic anaemia, thrombocytopenic purpura, nephrosis and hepatitis resulting from ingestion of a compound containing apiol. Canad. M.A.J 78: 195 1958;
  • 18 Moriau M. Inhibiteurs naturels de la fibrinolyse et phénomènes thrombohémorrhagiques. Pathologia europaea 04 Suppl. 179 1969;
  • 19 Perlick E. Gerinnungslaboratorium in Klinik und Praxis. G. Thieme; Leipzig: 1960
  • 20 Rath C. E, Maillard I. A, Schreiner G. E. Bleeding tendency in uremia. N. Engl. J. Med 257: 808 1957;
  • 21 Ratnojf O. D, Menzie C. A new method for the determination of fibrinogen in small samples of plasma. J. Lab. clin. Med 37: 316 1951;
  • 22 Salzman E. W, Neri L. L. Adhesiveness of blood platelets in uraemia. Thrombos. Diathes. haemorrh. (Stuttg) 15: 84 1966;
  • 23 Sorrier J. B, Stewart J. H, Castaldi P. A. The Effect of urea on the aggregation of normal human platelets. Thrombos. Diathes. haemorrh. (Stuttg) 19: 64 1969;
  • 24 Spöttl F, Constantini R. Die Bedeutung des Proaktivators im fibrinolytischen Fermentsystem. Thrombos. Diathes. haemorrh. (Stuttg) 18: 416 1967;
  • 25 Steichele D. T, Herschlein H. J. Untersuchung über die Fibrinolyse bei Äquivalenten des Sanarelli-Schwartzman Phänomen in der Geburtshilfe. Immunochemischer Nachweis von Fibrin(ogen)derivaten. Thrombos. Diathes. haemorrh. (Stuttg) 18: 311 1967;
  • 26 De Vries S. I, ten Cate J. W, den Hartog M. E. Veerman Quelques remarques sur la throm- bocytopathie acquise des urémiques. Hématologia 02: 89 1968;
  • 27 Weber E, Malessa S, Lasch H. G. Veränderungen der freien Thrombocytennukleotide beim Sanarelli-Schwartzman Phänomen. Thrombos. Diathes. haemorrh. (Stuttg) 09: 304 1963;
  • 28 Wright H. P. Adhesiveness of blood platelet in normal subjects and with varying concentrations of anticoagulants. J. Path. Bact 53: 255 1941;