Haemostasis is abnormal in uraemic patients with end-stage chronic renal failure. There is a risk of bleeding due to a failure of primary haemostasis,1yet at the same time arteriovenous shunt thrombosis is common2and the incidence of occlusive arterial disease is increased.3Both bleeding and thrombotic tendencies thus co-exist. There is a great deal of information about the former, less about the latter.