Uremic bleeding syndrome - Revision history

Danbot: Add evidence-based Disposition section

2026-03-22T10:03:54Z

Add evidence-based Disposition section

← Older revision		Revision as of 10:03, 22 March 2026
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	#*Gelatin - Gelfoam or Surgifoam		#*Gelatin - Gelfoam or Surgifoam
	#*Thrombin - Floseal		#*Thrombin - Floseal

			==Disposition==
			*Admit all patients with active uremic bleeding
			*Nephrology consultation for dialysis consideration
			*ICU admission for hemodynamically significant bleeding
			*Discharge only if bleeding controlled and adequate outpatient dialysis access confirmed

	==See Also==		==See Also==

2019-10-17T14:46:08Z

← Older revision		Revision as of 14:46, 17 October 2019
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	#Acute dialysis		#Acute [[dialysis]]
	#*[[pRBCs]]		#*[[pRBCs]]
	#**Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time

2019-10-01T19:06:28Z

← Older revision		Revision as of 19:06, 1 October 2019
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	==Background==		==Background==
	*Bleeding diathesis		*[[coagulopathy\|Bleeding diathesis]]
	**Increased risk for of bleeding (GI, ICH, liver hematoma) due to impaired ~~platlet~~ function		**Increased risk for of bleeding ([[GI bleed\|GI]], [[ICH]], liver hematoma) due to impaired platelet function
	*Uremic toxins inhibit platelet aggregation		*Uremic toxins inhibit platelet aggregation
	**Disrupts vWF		**Disrupts vWF
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	==Clinical Features==		==Clinical Features==
	*Wide range of presentations		*Wide range of presentations
	**Ecchymosis, purpura, epistaxis, fistula bleeding, venipuncture bleeding		**Ecchymosis, [[purpura]], [[epistaxis]], [[hemorrhage of AV fistula\|fistula bleeding]], venipuncture bleeding
	**GI bleeding		**[[GI bleeding]]
	**Intracranial bleeding		**[[ICH\|Intracranial bleeding]]

	==Differential Diagnosis==		==Differential Diagnosis==

2016-07-26T11:27:51Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 11:27, 26 July 2016
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	{{Increased bleeding DDX}}		{{Increased bleeding DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Bleeding time extended past 1-7 min (small incision on finger)		*Bleeding time extended past 1-7 min (small incision on finger)
	*Mild thrombocytopenia but plts rarely fall below 80k		*Mild thrombocytopenia but plts rarely fall below 80k

2016-07-21T12:16:06Z

Text replacement - "6 mg" to "6mg"

← Older revision		Revision as of 12:16, 21 July 2016
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	**Cryoprecipitate 10 bags over 30 min - benefit seen within 4-12 hrs in most<ref>Cryoprecipitate - Dosing and Uses. Medscape. http://reference.medscape.com/drug/cryo-cryoprecipitate-999498.</ref>		**Cryoprecipitate 10 bags over 30 min - benefit seen within 4-12 hrs in most<ref>Cryoprecipitate - Dosing and Uses. Medscape. http://reference.medscape.com/drug/cryo-cryoprecipitate-999498.</ref>
	**Recombinant EPO 50 - 150 u/kg IV 3x/wk		**Recombinant EPO 50 - 150 u/kg IV 3x/wk
	**Conjugated estrogens at 0.~~6 mg~~/kg IV over 30 min QD for 5 days - time to effect ~ 6 hrs, max effect at 1 wk, duration of action 2 wks		**Conjugated estrogens at 0.6mg/kg IV over 30 min QD for 5 days - time to effect ~ 6 hrs, max effect at 1 wk, duration of action 2 wks

2016-03-22T14:08:26Z

Text replacement - "Category:Nephro" to "Category:Renal"

2015-11-08T11:52:04Z

Management

← Older revision		Revision as of 11:52, 8 November 2015
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	#*[[pRBCs]]		#*[[pRBCs]]
	#**Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time
	#[[Desmopressin]]		#[[Desmopressin]] (DDAVP)
	#*Simplest and least toxic acute treatment		#*Simplest and least toxic acute treatment
	#*Increases release of factor VIII:von Willebrand factor multimers		#*Increases release of factor VIII:von Willebrand factor multimers

2015-11-08T11:50:58Z

Management

← Older revision		Revision as of 11:50, 8 November 2015
Line 34:		Line 34:
	#*[[pRBCs]]		#*[[pRBCs]]
	#**Raising HCT to above 25-30% improves bleeding time		#**Raising HCT to above 25-30% improves bleeding time
	#*[[Desmopressin]]		#[[Desmopressin]]
	#**Simplest and least toxic acute treatment		#*Simplest and least toxic acute treatment
	#**Increases release of factor VIII:von Willebrand factor multimers		#*Increases release of factor VIII:von Willebrand factor multimers
	#**0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.		#*0.3 mcg/kg IV (preferred) or SC (max 20mg). 3mcg/kg intranasaly is an option.
	#**Onset of action ~1hr, duration of action ~4-24hr		#*Onset of action ~1hr, duration of action ~4-24hr
	#Estrogen		#Estrogen
	#*Unclear mechanism of action		#*Unclear mechanism of action

2015-11-08T11:50:06Z

Treatment

← Older revision		Revision as of 11:50, 8 November 2015
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	**Conjugated estrogens at 0.6 mg/kg IV over 30 min QD for 5 days - time to effect ~ 6 hrs, max effect at 1 wk, duration of action 2 wks		**Conjugated estrogens at 0.6 mg/kg IV over 30 min QD for 5 days - time to effect ~ 6 hrs, max effect at 1 wk, duration of action 2 wks

	~~==Treatment==~~

	#Acute dialysis		#Acute dialysis
	#*[[pRBCs]]		#*[[pRBCs]]

2015-11-08T11:49:57Z

Management

@@ Line 28: / Line 28: @@
 **Recombinant EPO 50 - 150 u/kg IV 3x/wk
 **Conjugated estrogens at 0.6 mg/kg IV over 30 min QD for 5 days - time to effect ~ 6 hrs, max effect at 1 wk, duration of action 2 wks
 ==See Also==