GANGGUAN HEMOSTASIS PADA PENYAKIT GINJAL KRONIK DERAJAT 5

Ketut Angga Aditya Putra Pramana
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Abstract

Patients with chronic kidney disease (CKD) develop hemostatic disorders mainly in the form of bleeding diatheses. Platelet dysfunction is the main factor responsible for hemorrhagic tendencies in advanced kidney disease. Anemia, dialysis, the accumulation of medications due to poor clearance, and anticoagulation used during dialysis have some role in causing impaired hemostasis in CKD patients. Platelet dysfunction occurs both as a result of intrinsic platelet abnormalities and impaired platelet-vessel wall interaction. The normal platelet response to vessel wall injury with platelet activation, recruitment, adhesion, and aggregation is defective in advanced renal failure. Dialysis may partially correct these defects, but cannot totally eliminate them. The hemodialysis process itself may in fact contribute to bleeding. Hemodialysis is also associated with thrombosis as a result of chronic platelet activation due to contact with artificial surfaces during dialysis.
慢性肾病,血压计5
慢性肾脏疾病(CKD)患者主要以出血性糖尿病的形式出现止血障碍。血小板功能障碍是导致晚期肾脏疾病出血倾向的主要因素。在CKD患者中,贫血、透析、清除不良引起的药物积累以及透析过程中使用的抗凝剂都可能导致其止血功能受损。血小板功能障碍的发生是由于固有的血小板异常和血小板-血管壁相互作用受损。正常的血小板对血管壁损伤的反应,包括血小板活化、募集、粘附和聚集,在晚期肾衰竭中是有缺陷的。透析可以部分纠正这些缺陷,但不能完全消除它们。事实上,血液透析过程本身可能导致出血。血液透析还与血栓形成有关,这是由于透析期间与人造表面接触导致的慢性血小板活化所致。
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