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Anticoagulation-related nephropathy.

D S Wheeler1, R P Giugliano2, J Rangaswami1,3

  • 1Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.

Journal of Thrombosis and Haemostasis : JTH
|December 17, 2015
PubMed
Summary
This summary is machine-generated.

Anticoagulation-related nephropathy (ARN) is a serious kidney complication linked to blood thinners. Early detection is key to prevent worsening kidney disease and reduce mortality risks.

Keywords:
International Normalized Ratioacute renal injuryanticoagulantsthrombinwarfarin

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Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Anticoagulation-related nephropathy (ARN) is an underdiagnosed kidney complication associated with anticoagulation therapy.
  • ARN presents as acute kidney injury (AKI) with an elevated International Normalized Ratio (INR) > 3.0, historically linked to warfarin use.

Purpose of the Study:

  • To review the pathophysiology, molecular mechanisms, clinical spectrum, and therapeutic interventions for ARN.
  • To discuss the potential for ARN with novel oral anticoagulants (NOACs) and compare its incidence and severity with warfarin.

Main Methods:

  • Review of existing literature on ARN, including case reports and animal studies.
  • Analysis of post hoc data from clinical trials comparing warfarin and NOACs regarding adverse renal outcomes.

Main Results:

  • ARN is associated with increased renal morbidity and all-cause mortality.
  • While traditionally linked to warfarin, ARN may also occur with NOACs.
  • A post hoc analysis found no significant difference in AKI rates between warfarin and NOACs.

Conclusions:

  • Prompt recognition and understanding of ARN are crucial for managing anticoagulation therapy.
  • Further research is needed to elucidate the differences in ARN incidence and severity between warfarin and NOACs.
  • Balancing the risks and benefits of anticoagulation requires a thorough understanding of ARN's impact on renal function and mortality.