Anticoagulant-Related Nephropathy in a Renal Transplant Recipient

IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy

“…We found 3 case series (n = 63) [1,3,4] and 29 case reports describing histologic findings in patients with ARN [2,. Thirty-seven out of 92 (40%) cases were compatible with IgAN.…”

“…To the best of our knowledge, at the present time, only 3 case series (n = 63) [1,3,4] and 29 case reports have described histologic information of patients with ARN [2,.…”

“…Only English language papers were reviewed. This search revealed 3 case series [1,3,4] and 29 case reports [2,, comprising a total of 92 further cases of adult patients with biopsy-proven ARN.…”

“…In a recent study, among 8636 native kidney biopsies reviewed at the Ohio State University Wexner Medical Center, only 41 cases (0.5%) showed deterioration in kidney function that could be related to anticoagulation [3]. Another retrospective study in 126 allograft biopsies from transplant recipients on long term anticoagulation (minimum of 2 years follow-up) reported that only one case presented features of ARN [2]. Hence, it appears that ARN is an infrequent diagnosis in daily clinical practice.…”

“…Anticoagulant-related nephropathy (ARN) was originally described in 2009 in a small case series of patients on oral anticoagulation with warfarin and unexplained acute kidney injury (AKI) plus microscopic or gross hematuria [1]. Although vitamin K antagonists (VKA) were the first drugs associated with this entity, it is now recognized that other agents such as direct-acting oral anticoagulants (DOAC), antiplatelet medications, heparin or even prohemorrhagic states may trigger a similar clinical picture [2,3]. Histologically, ARN is characterized by glomerular hemorrhage and acute tubular injury with profuse red blood cells (RBC) and hematic casts at the tubular level.…”