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Post Info TOPIC: INR
Dzdayscomin


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RE: INR
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I'm 1.8 and I'm doing ok with platelets at 46 so  with all the other improvements I would not worry either.

Of course it does take a while to stop bleeding if I cut myself....but If I don't be stupid and cut myself, voila...no problem ! :)

Now if I can just find where I left that spare liver ...things will really shape up !

 

Duane



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53yr M 1a acq 12/83 cirr pre tx MELD 17  tx nv diag 1/29/12  tx S/O 3/5/14  trans list.

EOT 5/28/14 UND 6/12/14 SVR 8/29/14 MELD 14 dx HCC 9/5/2014 tumor ablation 9/24/14

In the 10K lakes State It's not about us but those around us.
Rubye


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Well, it's all well over my head. :) Regardless, it's good to know it's not a worry at this point.

Thank you guys! 



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UNDETECTED 5/4/15 - 16 weeks after EOT, 1st treatment - Sovaldi and Olysio, Geno 1a, 67 year old with compensated cirrhosis, over 40 years with HCV.
Tig


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Malcolm,

Thanks for the explanation! It helps to understand the correlation between the components. I've seen more reference to the PT/PTT than the INR. Separate test. I've witnessed more use of the PT when determining clotting times in patients undergoing anti coagulant therapy with various anti coagulants/blood thinners. It's all interesting, but as you say, quite complicated. I appreciate it...

Tig



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Tig

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mallani


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Tig,

Whole Blood Viscosity is a very complex subject. That article was mostly referring to antiplatelet/ anticoagulant treatments.

Usually , cirrhotics have a higher WBV until end stage. Blood viscosity is determined by 2 factors- the cellular components and the plasma components. The cellular factors are mostly RBC's- the number, shape and 'stickiness'. Platelets would need to be very low (? <40K) before they factor in. The plasma viscosity is pretty constant even though it contains all the clotting factors.

Personally, I prefer the Prothrombin Time (PT) which measures the clotting time in seconds (Normal range: 11-13.5 seconds). Cheers.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Tig


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Malcolm,

I had mentioned the platelet scenario after reviewing a paper(s) that mentioned low Platelet counts  amount to a lower blood viscosity and can affect INR, but high platelet counts have no effect on the INR. Did I misinterpret that? Thanks for your help.

"Conversely, international normalized ratio is statistically significantly higher in low blood viscosity relative to hyperviscosity"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341636/

Tig



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Tig

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mallani


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Hi Linda,

The INR (International Normalised Ratio) has nothing to do with platelets. It is a more reliable way of measuring the Prothrombin Time (PT). As the liver produces the pro-coagulant blood factors, eg Factor 2 (prothrombin). Factor 5 and fibrinogen, as well as the anticoagulant factors, the INR is used to assess the liver's health. It is used in calculating the MELD score.

The normal range is 0.8- 1.2. Yours is just a bit up, so don't worry about it. Cheers.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Tig


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Linda,

While not being an expert on this, I think it's a combination of those two factors. A low Platelet count can cause an elevation in your INR. Your cirrhosis is also a contributing factor, but that should show signs of improvement due to your SVR. It will take time but any improvement is a good thing. I think as your platelet count recovers, you will likely see a normalization in your INR. At least that's my non professional opinion! If you're concerned, I would just ask your doctor for clarification on this.

Tig



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Tig

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Rubye


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My platelets are 86 now. They were 65 for quite awhile with a lower INR. I didn't think it was anything to be concerned about either but for some reason I kept wondering Good to know it's nothing to worry about.

Thanks Tig.



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Tig


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Hi Linda,

What is your platelet level? You may be experiencing a lower than normal platelet count which may be responsible for that elevation. It's not uncommon with liver disease to see an elevated INR. 

Tig

http://www.nlm.nih.gov/medlineplus/ency/article/003652.htm

PS: I don't think  0.1 increase is anything to worry about. Patients on anti coagulants can see a level between 2 and 3.0. 



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Tig

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Rubye


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Does anyone know if a move from 1.11 to 1.22 INR means anything serious? Everything else is perfectly normal and Alk Phos, AST, and ALT are all mid-range normal. But, it's always been below 1.20 previously.

 



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