Anticoagulants and acute kidney injury: clinical and pathology considerations

Kidney Research and Clinical Practice
Sergey V Brodsky

Abstract

We have recently identified a new clinical syndrome in patients receiving warfarin for anticoagulation therapy. This syndrome has been named warfarin-related nephropathy (WRN), and patients with chronic kidney disease (CKD) appear to be particularly susceptible. WRN is defined as an acute increase in international normalized ratio (INR) to >3.0, followed by evidence of acute kidney injury (AKI) within 1 week of the INR increase. AKI was defined as a sustained increase in serum creatinine of greater than or equal to 0.3 mg/dL. The AKI cannot be explained by any other factors, and the kidney biopsy demonstrates extensive glomerular hemorrhage with tubular obstruction by red blood cells (RBCs). Beyond AKI, WRN is a significant risk factor for mortality within the first 2 months of diagnosis and it accelerates the progression of CKD. We demonstrated that 5/6 nephrectomy in rats is a suitable experimental model to study WRN. Animals treated with warfarin showed an increase in serum creatinine and morphologic findings in the kidney similar to those in humans with WRN. Our recent evidence suggests that novel oral anticoagulants may induce AKI. Diagnosis of WRN may be challenging for a renal pathologist. A few cases with suspected WRN ...Continue Reading

Citations

Oct 19, 2019·Drug and Therapeutics Bulletin·Christina DiMariaJames Reichart
Jun 30, 2019·BMJ : British Medical Journal·Indre K SemogasNicholas M P Annear
Aug 30, 2017·BMJ Case Reports·Basma AbdulhadiJanani Rangaswami
Mar 2, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Allison A Eddy
Jul 1, 2019·BMJ Case Reports·Christina DiMariaJames Reichart
Oct 31, 2019·Archives of Toxicology·João FariaRosalinde Masereeuw
Jun 15, 2019·Clinical Kidney Journal·Karolinny Borinelli de Aquino MouraAndré Luis Ferreira Azeredo da Silva
Apr 29, 2015·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Vinay Narasimha KrishnaDana V Rizk
Feb 10, 2018·British Journal of Clinical Pharmacology·Sapan Kumar BeheraBheemanathi Hanuman Srinivas
Feb 11, 2021·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Kee Tat LeeBoon Huei Kong
Mar 7, 2021·Journal of Clinical Medicine·Tanja Belčič MikičŽeljka Večerić-Haler

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy
biopsies
light microscopy

Related Concepts

Related Feeds

Related Papers

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Margaret RyanSergey V Brodsky
Journal of the American Society of Nephrology : JASN
Kyle M WareSergey V Brodsky
Drug Safety : an International Journal of Medical Toxicology and Drug Experience
Vinay Narasimha KrishnaDana V Rizk
© 2022 Meta ULC. All rights reserved