Why do people with renal failure bruise easily?

[DarkLotus]

It's late and I am stumped! Any suggestions on why people who have renal failure bruise so easily?

Thanks

[NRSKarenRN, BSN, RN]

Skin Problems and Kidney Disorders (Renalife)

Changes in the skin are usually marked. The skin is often pale which is related to secondary chronic anemia. A yellowish hue to the skin and dark hyperpigmentation to sun exposed areas have also been seen in many chronic renal patients. Extensive bruising of the skin, because of the problems with platelets and other hemostatic abnormalities, is often seen. Because of chronic dehydration, the patient's skin is usually dry and has a poor texture. Some patients experience firm plaques or nodules on the surfaces of the larger joints with a chalky material exuding because of calcium deposits in the skin.

[classicdame, MSN, EdD]

low albumin makes vessels "leak"

[nurseprnRN, BSN, RN]

many folks with renal failure are also on steroids for something or other, makes for excess capillary fragility and decreased platelets. anemia of chronic illness affects platelet production too. so minor bumps that would never bruise you will result in bruising.

dialysis patients may have a little leftover anticoagulation on board after a run.

lots of dialysis patients also have diabetes, and lots of diabetics have heart disease for which they take anticoagulation or meds with anticoag effects.

@classicdame: capillary vessels aren't solid, they're sort of tiled, and there are spaces between the cells making up the capillary wall. so fluid shifts there are common; it's why we have a lymphatic system, and it's what allows white cells to slither out to an infected area. edema from low serum albumin is fluid that leaks out because of low serum oncotic pressure, it's not whole blood containing red cells. the holes are too small to allow red cells to pass through unless there's damage (and it won't take much if any of the above are in play). it's red cells that make for bruising.