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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

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Warfarin: A double-edged sword.

Prabhakar Yadav¹, Sonal Yadav², Saurabh Pathak³

¹Consultant Nephrologist, Tata Main Hospital, Jamshedpur, Jharkhand, India.

Journal of Family Medicine and Primary Care

|November 5, 2019

Summary

Warfarin-related nephropathy (WRN) is a rare cause of acute kidney injury (AKI) from excessive anticoagulation. Prompt diagnosis and management, including withholding warfarin, can help prevent irreversible kidney damage.

Keywords:

Acute kidney injury warfarin warfarin-related nephropathy

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Area of Science:

Nephrology
Cardiology
Pharmacology

Background:

Warfarin is a widely used anticoagulant with a narrow therapeutic window.
Supratherapeutic anticoagulation can lead to serious complications, including Warfarin-related nephropathy (WRN).

Observation:

A 62-year-old male on long-term warfarin therapy presented with acute kidney injury (AKI).
Renal biopsy confirmed WRN, characterized by glomerular hemorrhage and RBC casts.

Findings:

WRN is a rare but serious cause of AKI in patients on warfarin.
Management involved withholding warfarin, achieving a therapeutic international normalized ratio, and supportive care with steroids and N-acetylcysteine.

Implications:

Early recognition and management of WRN are crucial to prevent irreversible kidney injury.
Periodic monitoring of renal function and anticoagulation levels is essential for patients on long-term warfarin therapy.