Uraemic Bleeding : Contributory Role Of Red Cells

The bleeding times (B.T.) of 65 patients with chronic uraemia were determined inmediately before a routine haonodialysis session. A significant negative correlation (r=0.67, p < 0.01) was found between B.T. and packed cell volume (PCV) values. When the patients with bleeding times longer than 15 min were excluded frcm the analysis, a negative correlation with PCV was still apparent (r = 0.55; p<0.01 ) .in addition, X2 analysis showed a significant association between PCV values <30% and B.T. longer than 260 sec(p<0.001) . Fourteen uraemic patients with PC/ values between 13% and 27% and B.T. longer than 15 min, required washed blood cell transfusions, after which PCV values increased variably but no shortening of B.T. was observed unless PCV rose to at least 30%. In particular, 2 uraemic patients with B.T. >15 min and PCV values of 21% and 19% were transfused on several occasions. PCV rose to 23%, 30% and 35% in the first patient and to 25% and 34% in the second one. The corresponding B.T. were >15 min,>15 min and 0 min 30 sec and > 15 and 9 min 30 sec. In a group of 15 patients with uraemia-unrelated anemias (PCV between 20% and 34%) the median B.T. was 300 sec (range 120-450 sec) whereas in a group of 15 uraemic patients with comparable PCV values, the median B.T. was 390 sec (range 180 - 900 sec) (p<0.05, paired student's t test) . It is concluded that among other factors red cells may contribute to the defective haemostasis in uraemic patients.