WILBERT J. HENKE, M.D.
To the editor: Patients having chronic hemodialysis for end-stage renal disease have an increased incidence of thromboembolic complications. Various factors may contribute to this problem, including trauma (shunts), multiple venous and arterial punctures, prolonged inactivity, and low levels of natural anticoagulants (1-4).
An 82-year-old woman who had been on hemodialysis for 5 years because of end-stage renal disease presented with a hypercoagulable state. Her Gortex shunt clotted five times at 5-day intervals. Treatment with thrombokinase and heparin failed to control the problem. The natural anticoagulant concentrations were antithrombin III, 92%; protein C, 45%; and free protein S, 81%.
WILBERT J. HENKE. Protein C and S Response to Danacrine in End-Stage Renal Disease. Ann Intern Med. 1988;108:910. doi: 10.7326/0003-4819-108-6-910_1
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Published: Ann Intern Med. 1988;108(6):910.
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