[Changes in hemostasis in dogs with chronic renal insufficiency].

The study enclosed 30 dogs with severe or end stage chronic renal failure showing distinctly increased concentrations of urea and creatinine. In most of the 15 cases, where a pathologic-histological investigation of the kidney was carried out, a glomerulonephritis was observed (n = 11), partly accompanied by an interstitial nephritis or tubulonephrosis, respectively. Compared to the control group (n > or = 100) the most significant changes were the distinctly increased concentrations of fibrinogen (6.22 [2.95-11.83] g/l; median [minimum-maximum]) and activity of the coagulation factors V (median = 165%), VII (198%), X (176%), VIII:C (154%), and IX (178%) as well as of protein C (147%) (each: p < 0,0001 [Mann-Whitney-Test]). Thereby, the latter does not contribute to hypercoagulability in dogs with chronic renal insufficiency. The activity of antithrombin III was clearly diminished (69[41-112]%), and was closely correlated to the albumin concentration (r = 0.7000; p = 0.001) reflecting the joint renal loss of these proteins of nearly a size. Surprisingly a reagent dependent prolongation of the activated partial thromboplastin time appeared. Against that, a corresponding diminution of the activity of single coagulation factors was demonstrated only seldom, reaching only a small degree, and related almost exclusively to the contact activating system. Compared to the respecting reference range the concentrations of soluble fibrin or fibrin degradation products were increased in 15 or 21 (of 29) samples, and were, thereby, significantly higher than in the control group (p < 0.0001). This reflects the enhanced intravascular coagulation occurring possibly limited to the region of the renal alteration that should be more noticed in therapy.