[Use of plasmapheresis in multimodality correction of hemostasis disorders in patients with calculous pyelonephritis].

As many as 142 patients with calculous pyelonephritis were examined for the system of hemostasis. It is shown that pyelonephritis is characterized by hypercoagulation shifts according to the echitox test, by the high content of fibrinogen and its degradation products, thrombinemia, a decrease of the antithrombin III level, and by high heparin resistance of plasma. At the same time there was a reduction of fibrinolysis. Thirty-six patients with the most pronounced disorders of hemostasis underwent multimodality treatment including plasmapheresis which favoured an improvement of the patients' status. The body temperature declined, the signs of intoxication disappeared, and the well-being improved. Hypercoagulation tended to disappearance, whereas the content of fibrinogen and its degradation products decreased. The level of antithrombin III rose and plasma resistance to heparin disappeared. At the same time the characteristics of the paracoagulation tests identifying thrombinemia remained unchanged. No noticeable changes in fibrinolysis were recorded. It is suggested that plasmapheresis should be widely used in multimodality treatment of pyelonephritis.