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

BMC Nephrology
Chee Yong NgPuay Hoon Tan

Abstract

Warfarin 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. We 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. The 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.

References

Jul 7, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sergey V BrodskyTibor Nadasdy
Nov 19, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Juan Antonio MorenoJesús Egido
Apr 5, 2012·American Journal of Nephrology·A OzcanS V Brodsky
Jun 16, 2012·Kidney International·Keng T WooChoong M Chan
Apr 12, 2013·American Journal of Physiology. Renal Physiology·Kyle WareSergey V Brodsky
Sep 3, 2013·The New England Journal of Medicine·John W EikelboomUNKNOWN RE-ALIGN Investigators
Sep 7, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Margaret RyanSergey V Brodsky
Apr 11, 2015·Clinical Kidney Journal·Vittorio Di MasoGiuliano Boscutti

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Citations

Feb 10, 2018·British Journal of Clinical Pharmacology·Sapan Kumar BeheraBheemanathi Hanuman Srinivas
Aug 18, 2017·Drugs & Aging·Sana KhanMitchell H Rosner
Jun 21, 2019·Journal of Investigative Medicine High Impact Case Reports·Jiemin LiAzeem Mohammed

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Methods Mentioned

BETA
biopsy

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