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Coagulation in Kidney Disease

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Primer on Nephrology

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Abstract

Patients with kidney disease often exhibit dysfunction of normal haemostasis. A wide range of abnormalities have been observed, and these patients are paradoxically at an increased risk of both bleeding and venous and arterial thromboembolism. Practical management of patients with renal dysfunction, from acute kidney injury to progressive chronic kidney disease (CKD) to those on long-term renal replacement therapy, should include an assessment of both bleeding and thrombotic risk and the balance between the two, along with an understanding of how haemostatic or anticoagulant therapy may affect this balance. The evaluation of risk-benefit between bleeding and prothrombotic tendency in individual patients can be challenging, and the lack of evidence-based guidelines or consensus recommendations for appropriate investigations and management compounds the problem.

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Acknowledgements

The authors wish to thank Duncan Brian, MBBS, MCRP, FRCPath, who wrote tirelessly for the chapter in the first edition of the textbook.

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Authors and Affiliations

  1. Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust, London, UK

    Nithya Prasannan & Pratima Chowdary

  2. Department of Haematology, University College London, London, UK

    Nithya Prasannan & Pratima Chowdary

  3. Department of Nephrology, The Royal London Hospital, Barts Health NHS Trust, London, UK

    Suzanne H. Forbes

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  1. Nithya Prasannan
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  2. Suzanne H. Forbes
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  3. Pratima Chowdary
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Correspondence to Pratima Chowdary .

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  1. Department of Renal Medicine, UCL, London, UK

    Mark Harber

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Prasannan, N., Forbes, S.H., Chowdary, P. (2022). Coagulation in Kidney Disease. In: Harber, M. (eds) Primer on Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-76419-7_75

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