Warfarin-related nephropathy

Golla, Anvesh; Goli, R; Nagalla, Vamsi Krishna; Kiran, Banigallapati Vijay; Raju, Sree Bhushan; Uppin, Megha S

doi:10.4103/ijn.ijn_3_17

Cited by 11 publications

(1 citation statement)

References 15 publications

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“…Although early administration of steroids has been reported to accelerate recovery from the more classic inflammation observed in drug (anticoagulants)-induced nephritis [ 20 , 21 , 22 , 23 , 24 ], the use of corticosteroids in ARN is still limited to a few reported cases [ 25 , 26 ]. Our decision to treat with steroids was based on clinical judgement and the extent of pathohistological changes associated with acute tubular injury.…”

Section: Discussionmentioning

confidence: 99%

Management of Anticoagulant-Related Nephropathy: A Single Center Experience

Mikič

Kojc

Frelih

et al. 2021

JCM

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Background: Anticoagulant-related nephropathy (ARN) is a form of acute kidney injury that mainly occurs in patients with previously unrecognized glomerular disease in addition to excessive anticoagulation. Since a renal biopsy is not performed in most cases, the diagnosis is often presumptive. Methods: Here, we present the characteristics of a national Slovenian patient cohort with histologically verified ARN, from the first case in 2014 to December 2020, and a review of the current literature (Pubmed database). Results: In Slovenia, ARN has been detected in 13 patients, seven of whom were treated with coumarins, and others with direct oral anticoagulants. In seven patients, ARN appeared after excessive anticoagulation. As many as 11 patients had underlying IgA nephropathy. Similar to the global data presented here, the pathohistological impairment associated with pre-existing glomerulopathy was mild and disproportionate to the degree of functional renal impairment. The majority of our patients with ARN experienced severe deterioration of renal function associated with histological signs of accompanying acute tubular injury, interstitial edema, and occlusive red blood cell casts. These patients were treated with corticosteroids, which (in addition to supportive treatment and discontinuation of the anticoagulant drug) led to a further improvement in renal function. Conclusions: Anticoagulant therapy combined with a pre-existing glomerular injury may lead to ARN. In addition to discontinuation of the anticoagulant and supportive care, corticosteroids, which are currently listed in only a few cases in the world literature, may have a positive influence on the course of treatment. However, the benefits of steroid treatment must be weighed against the risk of complications, especially life-threatening infections.

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Section: Discussionmentioning

confidence: 99%

Management of Anticoagulant-Related Nephropathy: A Single Center Experience

Mikič

Kojc

Frelih

et al. 2021

JCM

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Warfarin-related nephropathy: unveiling the hidden dangers of anticoagulation

Xu,

Wang,

Sun

et al. 2024

Clin Exp Med

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Warfarin-related nephropathy (WRN) is defined as acute kidney injury subsequent to excessive anticoagulation with warfarin. Patients with mechanical prosthetic valves require long-term anticoagulant therapy. Nonetheless, warfarin remains the sole available option for anticoagulant therapy. Consequently, patients with mechanical prosthetic valves constitute a special group among the entire anticoagulant population. The present study recorded two cases of patients who had undergone mechanical prosthetic valve surgery and were receiving warfarin therapy. They presented to the hospital with gross hematuria and progressive creatinine levels. Notably, their international normalized ratio (INR) did not exceed three. Subsequent renal biopsies confirmed WRN with IgA nephropathy. The two patients continued to receive warfarin as anticoagulation therapy and were prescribed oral corticosteroids and cyclophosphamide, which resulted in improved renal function during the follow-up. Based on a review of all relevant literature and the present study, we proposed a new challenge: must elevated INR levels be one of the criteria for clinical diagnosis of WRN? Perhaps some inspiration can be drawn from the present article.

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Acenocoumarol

2018

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Warfarin-related nephropathy

Cited by 11 publications

References 15 publications

Management of Anticoagulant-Related Nephropathy: A Single Center Experience

Management of Anticoagulant-Related Nephropathy: A Single Center Experience

Warfarin-related nephropathy: unveiling the hidden dangers of anticoagulation

Acenocoumarol

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