© 2019 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 197
Saudi Journal of Medicine
Abbreviated Key Title: Saudi J Med
ISSN 2518-3389 (Print) |ISSN 2518-3397 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: http://scholarsmepub.com/sjm/
Original Research Article
Haemostatic Status in Uraemics in UNTH, Enugu
Chukwurah Ejike Felix
1
, Obeagu Emmanuel Ifeanyi
2
*, Orjinta Rebecca Chinyelu
3
1
Department of Haematology and Immunology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria
2
Department of Medical Laboratory Science, Faculty of Health Sciences, Imo State University, Owerri, Nigeria
3
Department of Medical Laboratory Science, Faculty of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
*Corresponding author: Obeagu Emmanuel Ifeanyi | Received: 11.03.2019 | Accepted: 23.03.2019 | Published: 30.03.2019
DOI:10.21276/sjm.2019.4.3.7
Abstract
Uraemia is the clinical syndrome which occurs when there is a marked nitrogen retention due to renal failure. It had been
suggested that urea level has an effect on coagulation and haematological profile. The haemostatic status was studied in
Thirty known uraemic patients of the University of Nigeria Teaching Hospital Enugu. Fifteen non-uraemic people were
used as controls. The mean result obtained are as follows:-Packed cell volume (PCV), 29 ± 5.4%, Platelet count, 238 +
80.4 n 10
9
L, prothrombin time, 14.8 + 1.45 seconds, Bleeding time 5.9 + 1.98 minutes. For control subjects the following
result were obtained: Packed cell volume40.8 + 2.4%, Platelet count 267 ±48 x 10
9
L, Prothrombin time 12.9 +_0.93
seconds and Bleeding time 2.43 + 0.52 minutes. A statistical comparison of the above results between uraemic patients
and control subjects showed that there were no significant difference in the platelet count (P>0.20) and prothrombin time
(P>0.1) but showed significant difference in the packed cell volume and Bleeding time. A weakly positive correlation (r=
+ 0.11) was found to exit between prolongation of bleeding time and blood urea.
Keywords: Haemostatic status, uraemics, UNTH Enugu.
Copyright @ 2019: This is an open-access article distributed under the terms of the Creative Commons Attribution license which permits unrestricted
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INTRODUCTION
Urea is one of the end products of protein
metabolism. A normal adult ingests 10 - 15g of nitrogen
per day in dietary protein - on the average Ig nitrogen is
derived from about 6g protein [1]. The nitrogen is then
principally excreted in the urine as urea. Urea is formed
in the liver from deaminated amino acids, most
probably by way of the ornithine - arginine cycle [2].
Any excess urea in the circulation is
eliminated from the blood stream by the kidneys and
passed out in urine. In health, blood always contains
some urea. The level of urea in the blood varies but the
normal range is between 2.5 to 8.3 mmol per litre for a
normal person on a full ordinary diet [2].
With a fall in protein intake, there is a fall in
urea but a blood urea of over 8.3mmol/L is suggestive
of impaired renal function. Uraemia is the clinical
syndrome due to renal failure resulting from either
disease of the kidneys themselves or from disorders or
disease elsewhere in the body which induces the kidney
dysfunction and which results in gross biochemical
disturbance in the body including retention of urea and
other nitrogenous substances in the blood.
Uraemia is also the name given to the clinical
syndrome which occurs when there is a marked
nitrogen retention due to renal failure [1]. Acute renal
failure is present when there is a rapid rise in blood urea
or creatinine over a period of hours or a few days. It is
classified as pre-renal (depletion of the extracellular
fluid, ECF), Renal (acute tubular necrosis or acute
glomerulonephritis) and post-renal (obstruction to urine
flow). These cause acute uraemia [3].
Urea diffuses readily through body fluids so
that the estimation can be carried through whatever
body fluids are most readily available - whole blood,
serum, plasma, CSF, Oedema fluid.
It has been suggested that urea level has an
effect on coagulation and haematological profile -
Bleeding time, prothrombin time, platelet count, packed
cell volume and whole blood clotting time [1].
The bleeding time is one of the tests used to
study patients thought to be suffering from blood
clotting defects. In pathological conditions, bleeding
time can be shortened within 12 hours after acute
myoear4ial infarction [4] and also can be prolonged in
thrombocytopenia, von willebrand's disease. Acute
systemic lupus erythematosus, obstructive jaundice,
cardiac bypass surgery, glycogen storage disease type I,
disseminated intravascular coagulopathy, acute
fibrinolyois, cyanotic heart disease and uraemia [5].
Therefore if all the above pathological conditions are