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Anticoagulant-Related Nephropathy: A Common, Under-Diagnosed Clinical Entity
Agura Afiari1, Dimitrios Drekolias2, Jason Jacob3
1Department of Nephrology and Hypertension, MedStar Georgetown University Hospital, Washington, USA.
Anticoagulant-related nephropathy (ARN) causes acute kidney injury and hematuria in patients on anticoagulation. Diagnosis via kidney biopsy may lead to underreporting of this condition.
Area of Science:
- Nephrology
- Hematology
- Pharmacology
Background:
- Anticoagulant-related nephropathy (ARN), previously warfarin-induced nephropathy, is characterized by acute kidney injury (AKI) and hematuria.
- The exact pathogenesis of ARN is not fully understood.
- Diagnosis relies on kidney biopsy, potentially contributing to underdiagnosis.
Observation:
- Patients with ARN often present with supratherapeutic international normalized ratio (INR) levels.
- This case report details a patient experiencing AKI due to ARN.
- The clinical presentation highlights the importance of considering ARN in patients with AKI on anticoagulation.
Findings:
- The case illustrates a direct link between anticoagulation therapy and renal damage.
- Supratherapeutic INR values are a key indicator in ARN diagnosis.
- Kidney biopsy confirmed ARN as the cause of acute kidney injury.
Implications:
- Increased awareness and diagnostic vigilance for ARN are crucial.
- Further research into ARN pathogenesis may improve treatment strategies.
- Early recognition and management of ARN can potentially prevent severe kidney damage.
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