Abstract
Diabetes mellitus is a frequent cause of renal insufficiency. Fibrinolysis is either increased or, often, decreased.
However, the final stage of renal insufficiency is rather dominated by haemorrhagic diathesis. It is manifested by skin haemorrhage, mucosal manifestations, but also by retroperitoneal and cerebral haemorrhage.
The main cause of a haemorrhagic condition is platelet dysfunction combined with anticoagulant and antiplatelet therapy which is used in dialysis. Platelet function disorders are provoked by acquired thrombocytopenia and result in a disorder in the interaction between the blood vessel wall and the platelet.
Dialysis suppresses platelet abnormalities only temporarily by suppressing uremic toxins provoking platelet disorders. On the other hand, dialysis may cause prothrombotic activity.
Changes in haemostasis in type 2 diabetes mellitus form part of the insulin resistance syndrome and induce prothrombotic condition due to decreased fibrinolysis.