Uremia bleeding

Stool may be Hemoccult-positive if Gl bleeding occurs from uremia. 

Nonpharmacologic Therapy The incidence and severity of bleeding associated with uremia has decreased since dialysis has become the mainstay of treatment for ESRD. Dialysis initiation improves platelet function and reduces bleeding time.42 Improved care of the patient with ESRD, with anemia treatment and improvement in nutritional status, are also likely contributors to decreased uremic bleeding. 

Mannucci PM, Remuzzi G, Pusineri F, Lombardi R, Valsecchi C, Mecca G, Zimmerman TS. Deamino-8-D-argi-nine vasopressin shortens the bleeding time in uremia. N Engl J Med 1983 308(1) 8-12. 

No risk associated with food or therapeutic use at 1.5 g or less. Toxic reactions have been reported at a dose of 5 g including necrosis of the nose, thrombocytopenia and uremia collapse. Associated symptoms include vomiting, bleeding of the uterus, bloody diarrhea,... 

Patients with renal insufficiency are often found to be affected by multiple metabolic problems. Anaemia is often present and some of its causes are well identified, but can only partly explain the anaemia of such a severe degree as found in uremia. It is known that a certain degree of decreased erythropoiesis is present. Often occurs blood loss due to bleeding tendency. A third mechanism by which anaemia might develop is hemolysis, in fact the life-span of erythrocytes from uremic patients is shortened, but normal survival is noted when erythrocytes are injected into healthy persons. Erythrocytes from healthy subjects have a shortened survival time when injected into uremic patients. Thus, it seems that extracorpuscular factors account for the development of hemolysis. 

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