The degree to which kidney, liver & bone marrow disease
interfere with coagulation following oral surgical procedures
is not well understood. Although there are no randomised,
prospective studies, it is unlikely that individuals whose
kidney failure is well managed with dialysis would be at
increased risk for clinically significant bleeding, even from
multiple dental extractions.
In the case of dialysis for Chronic Renal Failure, patients are
heparinised for the time they are receiving dialysis, & they
could be anti-coagulated to some degree for several hours
Heparinisation, along with chronic anti-coagulation (eg
aspirin, warfarin), creates a multi-factorial coagulopathy
that puts a patient at higher risk for bleeding from oral
surgical procedures immediately following dialysis.
Although the half-life of heparin is approximately 4 hours,
dialysis is a long & fatiguing procedure, & for this reason
patients are better able to tolerate dental care on a
non-dialysis day. On the other hand, the longer a patient is
from their last dialysis, the more likely they are to have a
coagulopathy from uræmia.
|Last Updated 26th February 2014