Uremia affect INR?

[Interpolfanclub]

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Patient tonight 1 week of being unable to urinate, came in very SOB. Posted his labs in the HOF thread. BUN 269, Cr 35, bicarb 3. AG 55, pH 7.1

INR was 1.3 but while working to put in the Udall I thought he was bleeding more than usual. Uremia causes platelet dysfunction but would this be reflected in his coags? His PT and PTT were also normal.

There may be an easy answer to this question but I am too tired to think...

 

[Painter1]

Patient tonight 1 week of being unable to urinate, came in very SOB. Posted his labs in the HOF thread. BUN 269, Cr 35, bicarb 3. AG 55, pH 7.1

INR was 1.3 but while working to put in the Udall I thought he was bleeding more than usual. Uremia causes platelet dysfunction but would this be reflected in his coags? His PT and PTT were also normal.

There may be an easy answer to this question but I am too tired to think...

great question. uremic bleeding is not characterized by either pt or ptt. u just have to know that uremia causes platelet dysfunction.

 

[gutonc]

Nope, uremia just does platelets. If I had to guess, after a week of not peeing, he was pretty volume long. The mildly elevated INR was probably related to hepatic vascular congestion and will improve w/ HD.

People always get their knickers in a knot over elevated INRs and procedures but I'm way more worried about low platelets. Bleeding complications from high INRs are usually pretty quick and obvious. Platelet bleeding tends to be oozy and occult and may not show up for awhile. It's also usually why people bleed around lines and from puncture sites.