Hemostatic and fibrinolytic response to nasal desmopressin in hemodialysis patients

Med Princ Pract. 2004 Nov-Dec;13(6):340-5. doi: 10.1159/000080471.

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 microg/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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Administration, Intranasal
  • Bleeding Time
  • Blood Coagulation Factors / analysis
  • Blood Coagulation Factors / drug effects*
  • Deamino Arginine Vasopressin / pharmacology*
  • Female
  • Hemostatics / pharmacology*
  • Humans
  • Male
  • Middle Aged
  • Partial Thromboplastin Time
  • Renal Dialysis*

Substances

  • Blood Coagulation Factors
  • Hemostatics
  • Deamino Arginine Vasopressin