Anticoagulation and the kidney

  • C. Combe
  • M. Aparicio


Activation of local and systemic coagulation processes are induced by several renal diseases and may require specific anticoagulation therapy. The first parts of this chapter are devoted to these topics, including the influence of hemostasis and anticoagulation on the course of renal failure.


Peritoneal Dialysis Nephrotic Syndrome Chronic Renal Insufficiency Bleeding Tendency Uremic Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Addis T: Glomerular nephritis. Mac Millan, New-York 1948.Google Scholar
  2. 2.
    Akizawa T, Kinugasa E, Kitaoka T, Koshikawa S. Effects of recombinant human erythropoietin and correction of anemia on platelet function in hemodialysis patients. Nephron 58, 400–406, 1991.PubMedCrossRefGoogle Scholar
  3. 3.
    Andrassy K, Ritz E. Uremia as a cause of bleeding. Am J Nephrol 5, 313–319, 1985.PubMedCrossRefGoogle Scholar
  4. 4.
    Angles Cano E, Rondeau E, Delarue F, Hagege J, Sultan Y, Sraer JD. Identification and cellular localization of plasminogen activators from human glomeruli. Thromb Haemost 54, 688–692, 1985. PubMedGoogle Scholar
  5. 5.
    Ardaillou N, Hagege J, Nivez MP, Ardaillou R, Schlondorff D. Vasoconstrictor evoked prostaglandin synthesis in cultured human mesangial cells. Am J Physiol 248, F240–F246, 1985.PubMedGoogle Scholar
  6. 6.
    Boneu B, Buchanan MR, Caranobe C, Gabaig AM, Dupouy D, Sie P, Hirsh J. The disappearance of a low molecular weight heparin fraction (CY 216) differs from standard heparin in rabbits. Thromb Res 46, 845–853, 1987.PubMedCrossRefGoogle Scholar
  7. 7.
    Boneu B, Caranobe C, Sie P. Pharmacokinetics of heparin and low molecular weight heparin. In: Hirsch J (Ed). “Antithrombotic therapy”. Baillière-Tindall, London, vol 3, pp 531–534, 1990. Google Scholar
  8. 8.
    Border WA, Willson CB, Dixon FJ. Failure of heparin to affect two types of experimental glomerulonephritis in rabbits. Kidney Int 8, 140–148, 1975.PubMedCrossRefGoogle Scholar
  9. 9.
    Brown Z, Neild GH. Cyclosporine inhibits prostacyclin production by cultured human endothelial cells. Transplant Proc 19, 1178–1180, 1987.PubMedGoogle Scholar
  10. 10.
    Brown Z, Neild GH, Willoughby J et al. Factor VIII related antigen (FVIIIRAg) levels in renal allograft recipients taking cyclosporine (CS). Thromb Haemost 54, 292, 1985.Google Scholar
  11. 11.
    Cadroy Y, Pourrat J, Baladre MF, Saivin S, Houin G, Montastruc JL, Vernier I, Boneu B. Delayed elimination of enoxaparin in patients with chronic renal insufficiency. Thromb Res 63, 385–390, 1991.PubMedCrossRefGoogle Scholar
  12. 12.
    Camara I, De La Cruz JP, Frutos MA et al. Effects of dipyridamole on the short-term evolution of glomerulonephritis. Nephron 58, 13–16, 1991.PubMedCrossRefGoogle Scholar
  13. 13.
    Cameron JS. Coagulation and thromboembolic complications in the nephrotic syndrome. Adv Nephrol 13, 75–114, 1984.Google Scholar
  14. 14.
    CAMUSSI G. Potential role of platelet-activating factor in renal pathophysiology. Kidney Int 29, 469–477, 1986.PubMedCrossRefGoogle Scholar
  15. 15.
    Castellot JJ Jr, Hoover RL, Harper PA, Karnovsky MJ. Heparin and glomerular epithelial cell-secreted heparin like species inhibit mesangial cell proliferation. Am J Pathol 120, 427–435, 1985.Google Scholar
  16. 16.
    Colucci M, Semeraro N, Montemurro P, Chiumarulo P, Triggiani R, Morrone LF, Schena FP. Urinary procoagulant and fibrinolytic activity in human glomerulonephritis. Relationship with renal function. Kidney Int 39, 1213–1217, 1991.Google Scholar
  17. 17.
    Deprost D, Kanfer A. Quantitative assessment of procoagulant activity in isolated rat glomeruli. Kidney Int 28, 566–568, 1985.CrossRefGoogle Scholar
  18. 18.
    Deykin D. Uremic bleeding. Kidney Int 24, 698–705, 1983.PubMedCrossRefGoogle Scholar
  19. 19.
    Di Minno G, Martinez J, McKean ML, De La Rosa J, Burke JF, Murphy S. Platelet dysfunction in uremia multifaceted defect partially corrected by dialysis. Am J Med 79, 552–559, 1985.PubMedCrossRefGoogle Scholar
  20. 20.
    Donadio JV Jr, Anderson CF, Mitchell JC 3d, Holley KE, Ilstrup DM, Fuster V, Cheselbro JH. Membranoproliferative glomerulonephr it is. A prospective clinical trial of platelet- inhibitor therapy. N Engl J Med 310, 1421–1426, 1984. PubMedCrossRefGoogle Scholar
  21. 21.
    Drake TA, Morrissey JH, Edgington TS. Selective cellular expression of tissue factor in human tissues. Implications for disorders of hemostasis and thrombosis. Am J Pathol 134, 1087–1097, 1989.Google Scholar
  22. 22.
    Eschbach JW, Adamson JW. Hematologic consequences of renal failure. In: Brenner BM, Rector FC (Eds). “The kidney”. Saunders, Boston, pp 2019–2035, 1991.Google Scholar
  23. 23.
    Farrell PC, Ward RA, Schindhelm K, Gotch FA. Precise anticoagulation for routine hemodialysis. J Lab Clin Med 92, 164–176, 1978.PubMedGoogle Scholar
  24. 24.
    Fisher AM, Tapon-Bretaudiere J, Bros A, Josso F. Respective roles of antithrombin III and a—2—macroglobulin in thrombin inactivation. Thromb Haemost 45, 51–54, 1981.Google Scholar
  25. 25.
    Flanigan MJ, Von Brecht J, Freeman RM et al. Reducing the hemorrhagic complications of dialysis: a controlled comparison of low dose heparin and citrate anticoagulation. Am J Kidney Dis 9, 147–153, 1983.Google Scholar
  26. 26.
    Friedlander G, Moulonguet-Doleris L, Kourilsky O, Nussaume O, Ardaillou R, Sraer VD. Prostaglandin synthesis by isolated glomeruli from normal and chronically rejected human kidneys. Contr Nephrol 41, 20–22, 1984.Google Scholar
  27. 27.
    Furman KI, Gomperts ED, Hockley J. Activity of intraperitoneal heparin during peritoneal dialysis. Clin Nephrol 9, 15–18, 1978.PubMedGoogle Scholar
  28. 28.
    Glassock RJ, Adler SG, Ward HJ, Cohen AH: Primary glomerular diseases. In: Brenner BM, Rector FC (Eds). “The Kidney”. Saunders, Boston, pp 1182–1279, 1991.Google Scholar
  29. 29.
    Goudable C, Saivin S, Houin G, Sie P, Boneu B, Tonthat H, Suc JM. Pharmacokinetics of a low molecular weight heparin (Fraxiparine) in various stages of chronic renal failure. Nephron 59, 543–545, 1991.PubMedCrossRefGoogle Scholar
  30. 30.
    Gries E, Paar D, Graben N, Bock KD. How much heparin intraperitoneally is necessary in CAPD? Nephron 49, 256, 1988.PubMedCrossRefGoogle Scholar
  31. 31.
    Hancock W, Atkins RC. Activation of coagulation pathways and fibrin deposition in human glomeulonephritis. Semin Nephrol, 5, 69–77, 1985.PubMedGoogle Scholar
  32. 32.
    Handin RI, Loscalzo J. Hemostasis, thrombosis, fibrinolysis, and cardiovascular disease. In: Braunwald E (Ed). “Heart disease”. Saunders, Philadelphia, vol 3, pp 1758–1781, 1988.Google Scholar
  33. 33.
    Holdsworth SR, Tipping PG. Macrophage-induced glomerular fibrin deposition in experimental glomerulonephritis in the rabbit. J Clin Invest 76, 1367–1374, 1985.PubMedCrossRefGoogle Scholar
  34. 34.
    Horowitz HI, Stein IM, Cohen BD, White JG. Further studies on the platelet-inhibitory effect of guanidinosuccinic acid and its role in uremic bleeding. Am J Med 49, 336–345, 1970.PubMedCrossRefGoogle Scholar
  35. 35.
    Janson PA, Jubelirer SJ, Weinstein MJ, Deykin D. Treatment of the bleeding tendency in uremia with cryoprecipitate. N Engl J Med 303, 1318–1322, 1980.PubMedCrossRefGoogle Scholar
  36. 36.
    Jubelirer SJ. Hemostatic abnormalities in renal disease. Am J Kidney Dis 5, 219–225, 1985.PubMedGoogle Scholar
  37. 37.
    Kanfer A. Coagulation factors in nephrotic syndrome. Am J Nephrol 10, 63–68, 1990.PubMedCrossRefGoogle Scholar
  38. 38.
    Kanfer A, Rondeau E, Peraldi MN, Sraer JD. Coagulation in renal diseases: the role of the glomerular hemostasis system and implications for therapy. In: Andreucci VE, Fine LG (Eds). “International Yearbook of Nephrology 1992”. Springer-Verlag, London, pp 3–54, 1992.Google Scholar
  39. 39.
    Kant KS, Pollak VE, Dosekun A, Glas-Greenwalt P, Weiss MA, Glueck H. Lupus nephritis with thrombosis and abnormal fibrinolysis: effect of ancrod. J Lab Clin Med 33, 55–60, 1985.Google Scholar
  40. 40.
    Kincaid-Smith P. Coagulation and renal disease. Kidney Int 2, 183–190, 1973.CrossRefGoogle Scholar
  41. 41.
    Kincaid-Smith P. Participation of intra-vascular coagulation in the pathogenesis of glomerular and vascular lesions. Kidney Int 7, 242–253, 1975.PubMedCrossRefGoogle Scholar
  42. 42.
    Klahr S, Schreiner G, Ichikawa I. The progression of renal disease. N Engl J Med 318, 1657–1666, 1988.PubMedCrossRefGoogle Scholar
  43. 43.
    Kuzniewski M, Sulowicz W, Hanicki Z, Kus J, Nowogrodzka-Zagorska M, Kostka-Trabka E, Bieron K, Debinska-Kiec A. Effect of heparin and prostacyclin/heparin infusion on platelet aggregation in hemodialyzed patients. Nephron 56, 174–178, 1990.PubMedCrossRefGoogle Scholar
  44. 44.
    Lacave R, Rondeau E, Ochi S, Delarue F, Schleuning WD, Sraer JD. Characterization of a plasminogen activator and its inhibitor in human mesangial cells. Kidney Int 35, 806–811, 1989.PubMedCrossRefGoogle Scholar
  45. 45.
    Lambert PH, Dixon FJ. Pathogenesis of the glomerulonephritis of NZB/W mice. J Exp Med 127, 507–518, 1978.CrossRefGoogle Scholar
  46. 46.
    Lindsay R, Friesen M, Aronstam A, Andrus F. Improvement of platelet function by increased frequency of hemodialysis. Clin Nephrol 10, 67–70, 1978.PubMedGoogle Scholar
  47. 47.
    Lindsay RM, Smith AM. Pratical use of anticoagulants. In: Mäher JF (Ed). “Replacement of renal function by dialysis”. Kluwer, Dordrecht, pp 246–275, 1989.Google Scholar
  48. 48.
    Manucci P, Remuzzi G, Pusineri F, Lombardi R. Deamino-8-d-arginine vasopressin shortens the bleeding time in uremia. N Engl J Med 308, 8–12, 1983.CrossRefGoogle Scholar
  49. 49.
    Mohammad SF. Extracorporeal thrombogenesis: mechanisms and prevention. In: Maher JF (Ed). “Replacement of renal function by dialysis”. Kluwer, Dordrecht, pp 229–245, 1989.Google Scholar
  50. 50.
    Moia M, Vizzotto L, Cattanco M, Manucci PM, Casati S, Ponticelli C. Improvement in the haemostatic defect of uremia after treatment with recombinant erythropoietin Lancet i, 392–394, 1987. Google Scholar
  51. 51.
    Moriniere P, Dieval J, Bayrou B, et al. Low—molecular—weight heparin FraxiparinRin chronic hemodialysis. A dose-finding study. Blood Purif 7, 301–308, 1989. PubMedCrossRefGoogle Scholar
  52. 52.
    Myers BD. Cycloporine nephrotoxicity. Kidney Int 30, 964–974, 1986.PubMedCrossRefGoogle Scholar
  53. 53.
    Nawroth PP, Stern DM. Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163, 740–745, 1986.PubMedCrossRefGoogle Scholar
  54. 54.
    Norris SH. Renal eicosanoids. Sem Nephrol 10, 64–68, 1990.Google Scholar
  55. 55.
    Panicucci F, Sagripanti A, Pinori E, Vispi M, Lichini L, Barsotti G, Giovanette S. Comprehensive study of haemostasis in chronic uremia. Nephron 33, 5–8, 1983.PubMedCrossRefGoogle Scholar
  56. 56.
    Panicucci F, Sagripanti A, Vispi M, Pinori E, Lecchini L, Barsotti G, Giovanetti S. Comprehensive study of haemostasis in nephrotic syndrome. Nephron 33, 9–13, 1983.PubMedCrossRefGoogle Scholar
  57. 57.
    Pinnick RV, Weigmann TB, Diederich DA. Regional citrate anticoagulation for hemodialysis in the patient at high risk for bleeding. N Engl J Med 308, 258–261, 1983.PubMedCrossRefGoogle Scholar
  58. 58.
    Purkerson ML, Tollefsen DM, Klahr S. N—desulfated/acetylated heparin ameliorates the progression of renal disease in rats with subtotal renal ablation. J Clin Invest 81, 69–74, 1988.PubMedCrossRefGoogle Scholar
  59. 59.
    Rabiner SF, Molinas F. The role of phenol and phenolic acids on the thrombocytopathy and defective platelet aggregation of patients with renal failure. Am J Med 49, 346–351, 1970.PubMedCrossRefGoogle Scholar
  60. 60.
    Raugi GJ, Lovett DH. Thrombospondin secretion by cultured human glomerular mesangial cells. Am J Pathol 129, 364–372, 1987.PubMedGoogle Scholar
  61. 61.
    Remuzzi G, Hus and TTP. Variable expression of a single entity. Kidney Int 32, 292–302 1987.Google Scholar
  62. 62.
    Remuzzi G, Benigni A, Dodesini P, Schiepatti A, Livio M, De Gaetano G, Day JS, Smith WL, Pinca E, Patrignani P, Patrono C. Reduced platelet thromboxane formation in uremia. J Clin Invest 71, 762–768, 1983.PubMedCrossRefGoogle Scholar
  63. 63.
    Remuzzi G, Marchesi D, Cavenaghi AE, Livio M, Donati MB, De Gaetano G, Mecca G. Bleeding in renal failure: a possible role for vascular prostacyclin (PGI2). Clin Nephrol 12, 127–131, 1979.PubMedGoogle Scholar
  64. 64.
    Remuzzi G, Perico N, Zoja C, Corna D, Macconi D, Vigano G. Role of endothelium-derived nitric oxide in the bleeding tendency of uremia J Clin Invest 86, 1768–1771, 1990.Google Scholar
  65. 65.
    Rondeau E, Delarue F, Kanfer A, Nussaume O, Sraer JD. Profibrinolytic and procoagulant activities of human glomeruli from normal kidneys and rejected allograft. Fibrinolysis 2, 251–257, 1988.CrossRefGoogle Scholar
  66. 66.
    Rondeau E, Mougenot B, Lacave R, Peraldi MN, Kruithof EKO, Sraer JD. Plasminogen activator inhibitor in renal fibrin deposits of human nephropathies. Clin Nephrol 33, 55–60, 1990.PubMedGoogle Scholar
  67. 67.
    Rondeau E, Ochi S, Lacave R, He CJ, Medcalf RL, Delarue F, Sraer JD. Urokinase synthesis and binding by glomerular epithelial cells in culture. Kidney Int 36, 593–600, 1989.PubMedCrossRefGoogle Scholar
  68. 68.
    Sanders PW, Taylor H, Curtis J. Hemodialysis without anticoagulation. Am J Kidney Dis 5, 32–35, 1985.PubMedGoogle Scholar
  69. 69.
    Sargent JA, Gotch FA. Principles and biophysics of dialysis. In: Maher JF (Ed). “Replacement of renal function by dialysis”. Kluwer, Dordrecht, pp 87–143, 1989.Google Scholar
  70. 70.
    Schrader J, Stibbe W, Armstrong VW, Kandt M, Muche R, Kostering H, Seidel D, Scheler F. Comparison of low molecular weight heparin to standard heparin in hemodialysis/hemofiltra-tion. Kidney Int 33, 890–896, 1988.PubMedCrossRefGoogle Scholar
  71. 71.
    Schmitt GW, Moake JL, Rudy CK, Vicks SL, Hamburger RJ. Alterations in hemostatic parameters during hemodialysis with dialyzers of different membrane composition and flow design. Am J Med 83, 411–418, 1987.PubMedCrossRefGoogle Scholar
  72. 72.
    Sie P, Boneu B. Low molecular weight heparin half-life is prolonged in haemodialysis patients. Thromb Res 43, 1–5, 1986.PubMedCrossRefGoogle Scholar
  73. 73.
    Smith MC, Danviriyasup K, Crow JW, Cato AE, Park GD, Hassid A, Dunn MJ. Prostacyclin substitution for heparin in long-term hemodialysis. Am J Med. 73, 669–678, 1982.PubMedCrossRefGoogle Scholar
  74. 74.
    Sraer J, Wolf C, Oudinet JP, Bens M, Ardaillou R, Sraer JD. Human glomeruli release fatty acids which stimulate thromboxane synthesis in platelets. Kidney Int 32, 62–68, 1987.PubMedCrossRefGoogle Scholar
  75. 75.
    Striker GE, Soderland C, Bowen-Pope DF, Gown AM, Schmer G, Johnson A, Luchtel D, Ross R, Striker LJ. Isolation, characterization and propagation in vitro of human glomerular endothelial cells. J Exp Med 160, 323–328, 1984. PubMedCrossRefGoogle Scholar
  76. 76.
    Tabata T, Shimada H, Emoto M, Morita A, Furumitsu Y, Fujita J, Inoue T, Miki T, Nishizawa Y, Morii H. Inhibitory effect of heparin and/or antithrombin III on intraperitoneal fibrin formation in continuous anbulatory peritoneal dialysis. Nephron 56, 391–395, 1990.PubMedCrossRefGoogle Scholar
  77. 77.
    Thomson C, Forbes CD, Prentice CR. The potentiation of platelet aggregation and adhesion by heparin in vitro and in vivo. Clin Sei Mol Med 45, 485–494, 1973.Google Scholar
  78. 78.
    Vanrenterghem Y, Roels L, Lerut T, Gruwez J, Michielsen P, Gresle P, Deckmyn H, Colucci M, Arnout J, Vermylen J. Thromboembolic complications and haemostatic changes in cyclosporin-treated cadaveric allograft recipients. Lancet i, 999–1002, 1985. CrossRefGoogle Scholar
  79. 79.
    Vassalli P, McCluskey RT. The pathogenic role of the coagulation process in rabbit Masugi nephritis. Am J Pathol 45, 653–673, 1964.PubMedGoogle Scholar
  80. 80.
    Verbeelen D, Jochmans K, Herman AG, Van Der Niepen P, Sennesael J, De Waele M. Evaluation of platelets and hemostasis during hemodialysis with six different membranes. Nephron 59, 567–572, 1991.PubMedCrossRefGoogle Scholar
  81. 81.
    Wiggins RC, Njoku N, Sedor JR. Tissue factor production by cultured rat mesangial cells. Stimulation by TNFa and lipopoly saccharide. Kidney Int 37, 1281–1285, 1990.Google Scholar
  82. 82.
    Wilhelmsson S, Asaba H, Gunnarsson B, Kudry KB, Robinson D, Bergstrom J. Measurement of fibrinopeptide A in the evaluation of heparin activity and fibrin formation during hemodialysis. Clin Nephrol 15, 252–258, 1981.PubMedGoogle Scholar
  83. 83.
    Yoshida M, Kozaki M, Ioya N, Kaji N, Tamaki T, Hiraishi S, Ishii H, Kazama M, Fukutomi K, Nagasawa T. Plasma thrombomodulin levels as an indicator of vascular injury caused by cyclosporine nephrotoxicity. Transplantation 50, 1066–1069, 1990.PubMedCrossRefGoogle Scholar
  84. 84.
    Zimmmerman SW, Moorthy AV, Dreher WH, Friedman A, Varanasi U. Prospective trial of warfarin and dipyridamole in patients with membranoproliferative glomerulonephritis. Am J Med 75, 920–927, 1983.CrossRefGoogle Scholar
  85. 85.
    Zusman RM, Rubin RH, Cato AE, Cocchetto DM, Crow JW, Tolkoff-Rubin N. Hemodialysis using prostacyclin instead of heparin as the sole 86. antithrombotic agent. N Engl J Med 304, 934–939, 1981. PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 1994

Authors and Affiliations

  • C. Combe
  • M. Aparicio

There are no affiliations available

Personalised recommendations