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Anticoagulation-related nephropathy for the internist: a concise review
Kenechukwu Mezue1, Pradhum Ram2, Obiora Egbuche3
1Division of Hospital Medicine, Altru Health System Grand Forks, ND, USA.
American Journal of Cardiovascular Disease
|November 23, 2020
Summary
Anticoagulation-related nephropathy (ARN) is a poorly understood condition. This review discusses diagnosis and management strategies for ARN, particularly concerning direct-acting oral anticoagulants (DOACs).
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Anticoagulation-related nephropathy (ARN) is a significant clinical entity with high morbidity and mortality.
- ARN is often underdiagnosed and inadequately managed.
- While associated with warfarin, ARN's link to direct-acting oral anticoagulants (DOACs) is less established but increasingly concerning.
Purpose of the Study:
- To review the current understanding of Anticoagulation-related nephropathy (ARN).
- To highlight diagnostic measures for prompt ARN identification.
- To propose therapeutic strategies for managing ARN, especially in the context of DOAC use.
Main Methods:
- Literature review focusing on Anticoagulation-related nephropathy (ARN).
- Analysis of existing case reports and studies on warfarin and DOAC-associated kidney injury.
- Synthesis of information on clinical presentation, diagnosis, and management.
Main Results:
- ARN can lead to accelerated progression to chronic kidney disease (CKD) and end-stage renal disease (ESRD).
- The association between DOACs and ARN is an emerging concern with expanding DOAC usage.
- Early diagnosis and intervention are crucial for managing ARN.
Conclusions:
- There is a need for increased awareness and improved diagnostic approaches for ARN.
- Proactive management strategies are essential to mitigate the burden of ARN.
- Further research is warranted to fully elucidate the role of DOACs in ARN and optimize treatment.
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