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

Trujillo, Hernando; Pérez, Jose Javier Navarro; Cavero, Teresa; Caravaca-Fontán, Fernando; Gutiérrez, Eduardo; Sevillano, Ángel; Shabaka, Amir; Fernández-Juárez, Gema; Doyágüez, Pablo Rodríguez; Muñoz, Rocío Gimena; García, Lucila; Cabello, Virginia; Muñoz-Terol, José Manuel; Santiago, Ana García; Toldos, Óscar; Moreno, Juan Antonio; Praga, Manuel

doi:10.1016/j.ekir.2022.01.1048

Cited by 13 publications

(13 citation statements)

References 53 publications

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“…In the present study, patients with higher INR had a higher risk of severe AKI, which may be due to anticoagulant drugs used by patients with AMI. Excessive anticoagulation results in anticoagulation‐associated nephropathy with common pathological manifestations including hemorrhage and necrosis ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for severe acute kidney injury in patients with acute myocardial infarction: A retrospective study

et al. 2023

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BackgroundPatients with acute myocardial infarction (AMI) complicated by acute kidney injury (AKI) tend to have a poor prognosis. However, the exact mechanism of the co‐occurrence of the two diseases is unknown. Therefore, this study aims to determine the risk factors for severe AKI in patients with AMI.MethodsA total of 2022 patients were included in the Medical Information Mart for Intensive Care. Variables were identified via univariate logistic regression, and the variables were corrected via multivariate logistic regression. Restricted cubic splines were used to examine the risks associated with the variables. The Kaplan–Meier method was used to compare the risk of severe AKI among the patients.ResultsPatients with severe AKI had a higher in‐hospital mortality rate (28.6% vs. 9.0%, P < 0.001) and a longer duration of intensive care (6.5 days vs. 2.9 days, P < 0.001). In patients with AMI, the mean systolic blood pressure (SBP); international normalized ratio (INR); the levels of blood urea nitrogen (BUN), glucose, and calcium; and a history of liver disease were found to be the independent risk factors for developing severe AKI after their admission. Increased levels of BUN and blood glucose and a high INR increased the risk of severe AKI; however, increased levels of calcium decreased the risk; SBP presented a U‐shaped curve relationship.ConclusionsPatients with severe AKI have a poor prognosis following an episode of AMI. Furthermore, in patients with AMI, SBP; INR; a history of liver disease; and the levels of BUN, glucose, and calcium are the independent risk factors for developing severe AKI after their admission.

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Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for severe acute kidney injury in patients with acute myocardial infarction: A retrospective study

et al. 2023

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“…Along with rivaroxaban and dabigatran, anticoagulant-related nephropathy has also been associated with the use of vitamin K antagonists—acenokumarol and warfarin [ 147 ]. Ishii et al reported a case of a 55-year-old man who developed acute kidney injury as a result of taking warfarin for anticoagulant therapy.…”

Section: Iga Nephropathy Secondary To Iatrogenic Causesmentioning

confidence: 99%

Secondary IgA Nephropathy and IgA-Associated Nephropathy: A Systematic Review of Case Reports

Tota

Baron

Musial

et al. 2023

JCM

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Primary (pIgAN), secondary IgA nephropathy (sIgAN), and IgA-associated nephropathy can be distinguished. While pIgAN has been thoroughly studied, information about the etiology of sIgAN remains scarce. As concerns sIgAN, several studies suggest that different etiologic factors play a role and ultimately lead to a pathophysiologic process similar to that of pIgAN. In this article, we review a vast number of cases in order to determine the novel putative underlying diseases of sIgAN. Moreover, updates on the common pathophysiology of primary disorders and sIgAN are presented. We identified liver, gastrointestinal, oncological, dermatological, autoimmune, and respiratory diseases, as well as infectious, iatrogenic, and environmental factors, as triggers of sIgAN. As novel biological therapies for listed underlying diseases emerge, we suggest implementing drug-induced sIgAN as a new significant category. Clinicians should acknowledge the possibility of sIgAN progression in patients treated with TNF-α inhibitors, IL-12/IL-23-inhibitors, immune checkpoint inhibitors, CTLA-4, oral anticoagulants, thioureylene derivatives, and anti-vascular endothelial growth factor drugs.

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“…ARN is defined as AKI caused by oral anticoagulants such as warfarin and DOACs. 152,158 It is mainly manifested by impairment of the glomeruli filtration barrier with Bowman's space and tubular hemorrhage, resulting in tubular obstruction and occlusion. 159…”

Section: Arnmentioning

confidence: 99%

“…However, IgA nephropathy is considered as the most common underlying disease of ARN. 152 Warfarin, 153,154 dabigatran, 155,156 and aspirin 157 have been confirmed to induce ARN in patients with IgA nephropathy. Therefore, unnecessary anticoagulation in patients with IgA nephropathy may carry the risk of aggravating kidney injuries.…”

Section: Introductionmentioning

confidence: 99%

The Crosstalk between Nephropathy and Coagulation Disorder: Pathogenesis, Treatment, and Dilemmas

Qiu

Pang

Xiang

et al. 2023

JASN

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The interaction between the kidney and the coagulation system greatly impacts each other due to the abundant vessel distribution and blood perfusion in the kidney. Clinically, the risks of complicated thrombosis and bleeding have become important concerns in the treatment of nephropathies, especially nephrotic syndrome, chronic kidney disease, end-stage renal disease, and nephropathy patients undergoing renal replacement therapies. Adverse effects of anticoagulant or procoagulant therapies in nephropathy patients, especially anticoagulation-related nephropathy, heparin-induced thrombocytopenia, and bleeding, seriously worsen the prognosis of patients, which have become challenges for clinicians. Over the decades, the interaction between the kidney and the coagulation system has been widely studied. However, the effects of the kidney on the coagulation system have not been systematically investigated. Although some coagulation-related proteins and signaling pathways have been shown to improve coagulation abnormalities while avoiding additional kidney damage in certain kidney diseases, their potential as anticoagulation targets in nephropathy requires further investigation. Here, we review the progression of research on the crosstalk between the coagulation system and kidney diseases, and systematically analyze the significance and shortcomings of previous studies to provide new sight into future research. In addition, we highlight the status of clinical treatment for coagulation disorder and nephropathy caused by each other, indicating guidance for the formulation of therapeutic strategies or drug development.

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

Abstract: for the Spanish Group for the Study of Glomerular Diseases (GLOSEN), IgA nephropathy is the most common underlying disease in patients with anticoagulant-related nephropathy, Kidney International Reports (2022), doi:

Cited by 13 publications

References 53 publications

Analysis of risk factors for severe acute kidney injury in patients with acute myocardial infarction: A retrospective study

Analysis of risk factors for severe acute kidney injury in patients with acute myocardial infarction: A retrospective study

Secondary IgA Nephropathy and IgA-Associated Nephropathy: A Systematic Review of Case Reports

The Crosstalk between Nephropathy and Coagulation Disorder: Pathogenesis, Treatment, and Dilemmas

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