open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28
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Case report
Massive pulmonary embolism treated with a reduced dose of alteplase in a patient with acute renal failure

Waldemar Elikowski, Małgorzata Małek, Ilona Bar-Letkiewicz, Stanisław Kawczyński, Ryszard Prędki
Kardiol Pol 2008;66(8):885-888.

open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28

Abstract

There are some doubts whether in a severe renal failure the dose of alteplase should not be modified, especially when its plasma clearence may be decreased by liver ischemia. The authors present a case of a 67-year old woman with massive pulmonary embolism (PE) and acute renal failure (creatinine 580 µmol/l) of a mixed etiology (renal calculosis with hydronephrosis and shock as PE presentation). Alteplase administration (10 mg bolus followed by reduced to 50 mg two hours infusion) resulted in hemodynamic stabilization but was complicated by gross subcutaneous hematomas, intensive epistaxis and hematuria, and hemoglobin decrease which required blood transfusions.

Abstract

There are some doubts whether in a severe renal failure the dose of alteplase should not be modified, especially when its plasma clearence may be decreased by liver ischemia. The authors present a case of a 67-year old woman with massive pulmonary embolism (PE) and acute renal failure (creatinine 580 µmol/l) of a mixed etiology (renal calculosis with hydronephrosis and shock as PE presentation). Alteplase administration (10 mg bolus followed by reduced to 50 mg two hours infusion) resulted in hemodynamic stabilization but was complicated by gross subcutaneous hematomas, intensive epistaxis and hematuria, and hemoglobin decrease which required blood transfusions.
Get Citation

Keywords

massive pulmonary embolism; thrombolysis; acute renal failure; bleeding complications

About this article
Title

Case report
Massive pulmonary embolism treated with a reduced dose of alteplase in a patient with acute renal failure

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 8 (2008)

Pages

885-888

Published online

2008-08-27

Bibliographic record

Kardiol Pol 2008;66(8):885-888.

Keywords

massive pulmonary embolism
thrombolysis
acute renal failure
bleeding complications

Authors

Waldemar Elikowski
Małgorzata Małek
Ilona Bar-Letkiewicz
Stanisław Kawczyński
Ryszard Prędki

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