Accepted
at 3 p.m. Oct, 31, 2023
by
Dam_Doc
Author:
dillonjones.do
Type of change:
Other
Rationale for change
update to one by one card.
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After
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Text
What hematologic laboratory values are consistent with abnormal hemostasis due to chronic kidney disease?
PT: {{c1::Normal}}
PTT: {{c1::Normal}}
Platelet count: {{c1::Normal}}
Bleeding time: {{c1::Prolonged}}
Extra
Underlying cause is platelet dysfunction
Proposed mechanism
- ↑ urea → arginine shunted to guanidinosuccinic acid (GSA), precursor to nitric oxide
- ↑ nitric oxide → ↓ vWF secretion by endothelial cells → ↓ platelet adhesion
- ↑ nitric oxide → ↓ ADP and TXA2 / ↓ activation of GplIb/Illa receptor → ↓ platelet activation and aggregation
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