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Rivaroxaban-Induced Acute Interstitial Nephritis: A Case Report

Fahad Zafar1, Arshad Muhammad Iqbal1, Ateeq Mubarik1

  • 1Department of Internal Medicine, Oak Hill Hospital, Brooksville, FL, USA.

The American Journal of Case Reports
|November 22, 2019
PubMed

Insights

Direct oral anticoagulants like rivaroxaban are common, but can cause acute interstitial nephritis. This rare condition requires removing the drug and may need corticosteroid treatment.

Area of Science:

  • Nephrology
  • Pharmacology

Background:

  • Direct oral anticoagulants (DOACs) are increasingly used, often replacing warfarin for conditions like atrial fibrillation.
  • Rivaroxaban is a widely prescribed DOAC for anticoagulation and preventing thromboembolic events.

Observation:

  • A 70-year-old male developed acute interstitial nephritis after initiating rivaroxaban therapy.
  • The patient responded well to treatment including corticosteroids.

Findings:

  • Acute interstitial nephritis is a rare adverse effect associated with DOACs.
  • Renal biopsy was not performed due to the patient's high CHADS2VASc score necessitating continued anticoagulation.

Implications:

  • Rivaroxaban dose adjustments are crucial for patients with renal impairment.
  • Discontinuation of the offending agent and supportive care are key in managing drug-induced acute interstitial nephritis.

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