Warfarin related nephropathy: a case report and review of the literature

Abstract

BackgroundWarfarin related nephropathy is one of the potential complications of warfarin therapy. Despite the well described histological entity, the clinical course and approach to warfarin related nephropathy in patients requiring life-long anticoagulation is however not well described in the literature.Case presentationWe report the clinical course of a 56 years old Chinese lady who presented with over anti-coagulation and acute kidney injury while on warfarin therapy for permanent atrial fibrillation and mechanical valve replacement. Renal biopsy was performed as the acute kidney injury was persistent despite normalization of the International Normalized Ratio and the diagnosis of warfarin related nephropathy was made. Temporary interruption of anti-coagulation, in combination with oral N-acetylcysteine resulted in subsequent stabilization of renal function.ConclusionThe diagnosis of warfarin induced nephropathy should be considered in patients presenting with unexplained acute kidney injury and over anti-coagulation. Awareness of this clinical entity is important for clinician managing anti-coagulation therapy and renal function should be monitored regularly in patients who are on warfarin therapy.

Lactobacillus Endocarditis-Associated Glomerulonephritis Complicated by anti-Coagulant Nephropathy and Renal Amyloidosis

“…e amyloid deposits are most commonly of the light chain (AL) or inflammatory type (AA) [7,8]. e co-presence of warfarin-related nephropathy in patients with histories of bacterial endocarditis and endocarditis-associated glomerulonephritis have been documented [9,10].…”

Anticoagulant-related nephropathy in a patient with IgA nephropathy

“…To best of our knowledge, three cases of ARN in patients with IgA nephropathy have been reported: two cases occurred in patients treated with dabigatran6 7 and one in a case of anticoagulation with warfarin 9. Patients with chronic kidney disease are particularly susceptible, but there are other underlying risk factors, such as age, diabetes and diabetic nephropathy, arterial hypertension, glomerulonephritis and heart failure 10.…”

Warfarin related nephropathy: a case report from a tertiary hospital of north India and review of literature

“…[ 12,13 ] Temporary interruption of anti-coagulation in conjunction with N-acetylcystine has been shown to halt progression of renal dysfunction in WRN. [14] Steroid has been tried for its antiinflammatory action which can occur following glomerular hemorrhage and tubular obstruction in the kidney. [14,15]…”

“…[14] Steroid has been tried for its antiinflammatory action which can occur following glomerular hemorrhage and tubular obstruction in the kidney. [14,15]…”