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Intravascular Coagulation in Acute Renal Failure After Myocardial Infarction

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▸Requests for reprints should be addressed to Henryk Krug, M.D., ½ Długa St., 61-848 Poznań, Poland.

Poznań, Poland

Ann Intern Med. 1974;81(4):494-497. doi:10.7326/0003-4819-81-4-494
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Serial coagulation studies were performed on three patients with acute renal failure caused by cardiogenic shock. During sustained oliguria, despite improvement of hemodynamic conditions, an excessive rise in serum fibrin degradation product (FDP) concentrations concomitant with a decrease in the platelet count was shown, whereas the fibrinogen level and fibrinolytic activity remained within normal limits. After heparin treatment, a prompt improvement in urine output and renal function was seen, together with a sharp decrease in serum FDP. In two patients a significant rise in the platelet count was noted. These findings suggest that some cases of ischemic acute renal failure may be an example of localized intravascular coagulation. Two patients survived, one without clinical evidence of renal disease, and the second is hypertensive with impaired kidney function. The only fatality occurred after initial improvement and can be directly ascribed to severe myocardial reinfarction.





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