From Clot Prevention to Kidney Injury: Revisiting Anticoagulant-Related Nephropathy
Irene Martin Capon1, Paolo Nikolai So2, Tiffany Caza3
112 de Octubre University Hospital, Madrid, Spain.
Kidney & Blood Pressure Research
|January 26, 2026
Summary
Anticoagulant-related nephropathy (ARN) is a kidney complication from blood thinners, often missed and leading to poor outcomes. Early recognition and management are crucial for patients on anticoagulation therapy.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Anticoagulant-related nephropathy (ARN) is a kidney complication linked to anticoagulant therapies, including warfarin and direct oral anticoagulants (DOACs).
- ARN is characterized by acute kidney injury (AKI), hematuria, and red blood cell casts, often underdiagnosed, especially in patients with chronic kidney disease (CKD).
Purpose of the Study:
- This review aims to discuss the epidemiology, pathogenesis, diagnosis, and treatment of anticoagulant-related nephropathy (ARN).
Main Methods:
- The review synthesizes current evidence from epidemiological studies, clinical observations, and research on the mechanisms of ARN.
- It examines diagnostic criteria and evaluates existing and potential therapeutic strategies for ARN.
Main Results:
- ARN is more prevalent than previously thought and is associated with significant risks of poor kidney outcomes, with over 50% of patients not recovering baseline function.
- One-year mortality rates for non-recovering ARN patients can be as high as 39%.
Conclusions:
- Despite treatment options like anticoagulation withdrawal and supportive care, no definitive treatment for ARN currently exists.
- Further research is needed to improve the diagnosis and management of ARN to mitigate its severe consequences on kidney function and survival.
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