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Updated: Jun 24, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
[Can acute renal insufficiency increase the effect of warfarin?]
Bjarni Arnason1, Jakob Matthisson, Hanne Madsen
1Langelinie 59, DK-5230 Odense M. h.madsen@dadlnet.dk
Abstract:
The use of warfarin is complicated by its narrow therapeutic index. The risk of severe complications in the form of haemorrhage is significantly increased by an elevated degree of anticoagulation. We present a case in which a patient in stable warfarin treatment was admitted with acute renal failure and extremely high international normalized ratio (INR). No single mechanism can fully explain this. We find that it was probably caused by accumulation of active metabolites, an inhibitory factor in uraemic blood, which reduces hepatic metabolism and a genotype with an unstable metabolism of warfarin.
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