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CASE REPORT
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 76-78

Successful Hemodialysis Initiation in a Patient with Chronic Disseminated Intravascular Coagulation


1 Department of Nephrology, Nakatsugawa City Hospital, Nakatsugawa City, Gifu Prefecture, Nagoya, Japan
2 Department of Emergency Medicine, Nagoya Ekisaikai Hospital, Nagoya, Japan

Correspondence Address:
Akihito Tanaka
Department of Nephrology, Nakatsugawa City Hospital, 1522-1 Komaba, Nakatsugawa City, Gifu Prefecture - 5088502
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2225-1243.143388

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We report a 72-year-old man with end-stage renal disease due to chronic glomerulonephritis and chronic disseminated intravascular coagulation (DIC) caused by aortic aneurysm. He had had graft replacement for abdominal aortic aneurysm in 2012 at another hospital. He indicated development of thoracic aortic aneurysm, which developed chronic DIC with much subcutaneous hemorrhage. His renal function gradually decreased and we planned hemodialysis initiation. We administered camostat mesilate and platelet concentrate transfusion to treat hemorrhagic tendency before the arteriovenus fistula in May 2014. After the operation, we added tranexamic acid because of difficulty in hemostasis. About 1 month later, the patient reported with hemorrhage from the nose and his renal function was exacerbated. He was initiated into hemodialysis with transfusion of red blood cells and fresh frozen plasma. We raised the dose of camostat mesilate and adjusted the dose of anticoagulant with reference to activated clotting time. He was successfully initiated into dialysis without major trouble.


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