Uremia and coagulopathy

Q: Uremia prolongs? select one

A) PT

B) PTT

C) PT and PTT

D) Bleeding Time (BT)

E) PT, PTT, and BT

Answer: D

Uremia is unique in the sense that it doesn't affect PT or PTT. DDAVP is the first-line treatment, which acts promptly but has a short duration of action of a few hours and exhibits tachyphylaxis. 

Conjugated estrogens have also shown promise, but their onset of action is slower (approximately 6 hours), and the effect lasts for about 2 weeks.

#hematology

#lab-medicine

References:

1. Molino D, De Lucia D, Gaspare De Santo N. Coagulation disorders in uremia. Semin Nephrol. 2006 Jan;26(1):46-51. doi: 10.1016/j.semnephrol.2005.06.011. PMID: 16412826.

2. Brophy DF, Martin EJ, Carr SL, Kirschbaum B, Carr ME Jr. The effect of uremia on platelet contractile force, clot elastic modulus and bleeding time in hemodialysis patients. Thromb Res. 2007;119(6):723-9. doi: 10.1016/j.thromres.2006.02.013. Epub 2006 Jun 21. PMID: 16793120.