Abstract
Background:
Warfarin therapy can provoke severe hematuria and acute kidney injury with the presence of occlusive red blood cell casts. These findings are compatible with a recently described disease entity, warfarin related nephropathy, which adversely affects renal and patient outcome.
Case report:
We report a 74-year-old man with chronic kidney disease stage 3 A, who developed a decline in glomerular filtration rate (GFR) after the initiation of warfarin therapy due to of atrial fibrillation. The diagnosis could be confirmed by renal histology which showed occlusion of renal tubules by red blood cells and casts consistent with this diagnosis. The patient did not recover the GFR and started renal replacement therapy in June (fourteen months after starting warfarin) 2014.
Discussion:
The aim of the present report is to alert for this drug recognized complication and reinforce the need of carefully motorization of kidney function and coagulation parameters in patients treated with warfarin. The pathogenesis and outcome of warfarin-related nephropathy is also discussed here.
Keywords:
dialysis; kidney failure, chronic; medication therapy management
