Anticoagulant-related nephropathy

Abstract

Anticoagulant-associated nephropathy is a type of acute kidney injury caused by anticoagulation with warfarin or other anticoagulant agents. It appears that the risk of developing anticoagulant-associated nephropathy increases when INR>4. In this article, a case who developed acute kidney injury due to the use of a supratherapeutic dose of warfarin is presented. A 61-year-old male patient with comorbidities of obesity, hypertension, type 2 diabetes mellitus and chronic kidney disease, using warfarin due to atrial fibrillation, was admitted to the emergency room with swelling and bruising in his left flank. In the laboratory analysis of the patient who had hematoma in the left posterolateral wall of the chest, INR: 9.7 serum creatinine level was found above 2 times the baseline value (baseline value: 3.4 mg/dL, the highest: 6.2 mg/dL). Hemoglobin decreased to 6.8 g/dL. With the discontinuation of warfarin and decreaseing the INR to the safe range, the patient's serum creatinine regressed to the basal level. Other causes of acute renal injury were excluded and anticoagulant-associated nephropathy was thought to develop in the patient who used supratherapeutic dose of warfarin. This case shows that anticoagulant treatments require careful follow-up, especially in chronic kidney patients with high comorbidities. Anticoagulant-associated nephropathy should be kept in mind in the etiology of acute kidney injury in patients using anticoagulants.