TRANSDERMAL ESTROGENS - ARE THEY THE SOLU TION TO UREMIC BLEEDING

The increased bleeding tendency associated with renal failure is one o f the major complications of the uremic population. Several therapies have been used such as erythrocyte transfusion cryoprecipitate or deam ino-8-D-arginine vasopressin infusion and conjugated estrogens adminis tration. The last is highly effective but its use has been limited bec ause of its adverse effects, particularly in males. Therefore, long-te rm use oi these agents as transdermal preparations might be the optima l form of administration in order to minimize the side effects of oral or intravenous therapy. We describe the course of two patients with e nd-stage-renal disease on hemodialysis who had frequent episodes of an emia from gastrointestinal bleeding treated for ten, and six months re spectively, with 8 mg transdermally applied estradiol. Bleeding ceased in one patient and neither oi them had any significant side-effects. This shows the long term efficacy of this type of therapy.