CONJUGATED ESTROGENS FOR THE MANAGEMENT OF GASTROINTESTINAL-BLEEDING SECONDARY TO UREMIA OF ACUTE-RENAL-FAILURE

Bleeding commonly occurs secondary to the uremia of acute and chronic renal failure. Hemodialysis is indicated for the management of uremic bleeding, and administration of red blood cells and cryoprecipitate is also helpful. Desmopressin successfully reduces the bleeding tendency in patients with chronic renal failure for short-term operations or p rocedures, but the frequency of tachyphylaxis is high and limits the d rug's usefulness for major bleeds. Conjugated estrogens shorten bleedi ng times in uremia and may provide a more sustained hemostatic effect over desmopressin. A patient with acute renal failure and uncontrolled gastrointestinal bleeding was successfully treated with conjugated es trogens after failing desmopressin and octreotide therapy.