Wednesday, April 11, 2012

Preventing Bleeding (hematuria) in Polycystic Kidney Disease

Tranexamic Acid


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Tranexamic acid is by no means a new drug it has been used routinely in surgery, for years particularlywhere there is a high risk of bleeding. Acting to prevent the breakdown of fibrin one of the key components of a blood clot, this drug has been found to decrease the risk of death from multiple trauma and is considered an essential medication by the World Health Organization.



Recently a group of investigators published in the Journal Nepfrologia a pilot study that seems to suggest that patients with polycystic kidney disease have less bleeding when they are treated with reduced dosing of this agent. The aim of therapy is to reduce the need for further more invasive therapy in patients with life threatening bleeding.

Patients with Polycystic Kidney Disease may have episodes of self limited hemorrhage throughout the course of the their illness. In some cases this bleeding can be severe enough to require removal of the affected kidney or embolization (a method where a blood vessel is purposefully blocked to prevent bleeding, leading to the death of the tissue downstream as an unfortunate consequence). In a patient with Chronic Kidney Disease this would lead to a significant loss of kidney function and may result in an earlier start time for dialysis.

If tranexamic acid is found to be safe and effective in larger trials then this may pave the way for a simple kidney friendly therapy for bleeding in Polycystic Kidney Disease.

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