Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy
Joint Authors
Zeni, Letizia
Manenti, Chiara
Fisogni, Simona
Terlizzi, Vincenzo
Verzeletti, Federica
Gaggiotti, Mario
Cancarini, Giovanni
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-08
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
The relationship between kidneys and anticoagulation is complex, especially after introduction of the direct oral anticoagulants (DOAC).
It is recently growing evidence of an anticoagulant-related nephropathy (ARN), a form of acute kidney injury caused by excessive anticoagulation.
The pathogenesis of kidney damage in this setting is multifactorial, and nowadays, there is no established treatment.
We describe a case of ARN, admitted to our Nephrology Unit with a strong suspicion of ANCA-associated vasculitis due to gross haematuria and haemoptysis; the patient was being given dabigatran.
Renal biopsy excluded ANCA-associated vasculitis and diagnosed a red blood cell cast nephropathy superimposed to an underlying IgA nephropathy.
Several mechanisms are possibly responsible for kidney injury in ARN: tubular obstruction, cytotoxicity of heme-containing molecules and free iron, and activation of proinflammatory/profibrotic cytokines.
Therefore, the patient was given a multilevel strategy of treatment.
A combination of reversal of coagulopathy (i.e., withdrawal of dabigatran and infusion of its specific antidote) along with administration of fluids, sodium bicarbonate, steroids, and mannitol resulted in conservative management of AKI and fast recovery of renal function.
This observation could suggest a prospective study aiming to find the best therapy of ARN.
American Psychological Association (APA)
Zeni, Letizia& Manenti, Chiara& Fisogni, Simona& Terlizzi, Vincenzo& Verzeletti, Federica& Gaggiotti, Mario…[et al.]. 2020. Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy. Case Reports in Nephrology،Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1148844
Modern Language Association (MLA)
Zeni, Letizia…[et al.]. Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy. Case Reports in Nephrology No. 2020 (2020), pp.1-5.
https://search.emarefa.net/detail/BIM-1148844
American Medical Association (AMA)
Zeni, Letizia& Manenti, Chiara& Fisogni, Simona& Terlizzi, Vincenzo& Verzeletti, Federica& Gaggiotti, Mario…[et al.]. Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy. Case Reports in Nephrology. 2020. Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1148844
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1148844