Di Maso Vittorio, Carraro Michele, Bevilacqua Elena, Bucconi Sergio, Artero Mary Louise, Boscutti Giuliano
Nephrology and Dialysis Department , AOTS Trieste Hospital , Trieste , Italy.
Nephrology and Dialysis Department , AOTS Trieste Hospital , Trieste , Italy ; Department of Medical Sciences , University of Trieste , Trieste , Italy.
Clin Kidney J. 2014 Dec;7(6):605-8. doi: 10.1093/ckj/sfu112. Epub 2014 Oct 28.
Warfarin-related nephropathy (WRN) is a renal complication of warfarin treatment associated with over-anticoagulation. We describe a case of a 73-year-old man affected by chronic kidney disease, essential hypertension and atrial fibrillation treated with warfarin. The patient presented a rapid course of kidney failure after many episodes of over-anticoagulation, and renal biopsy demonstrated WRN. Interestingly, the patient's warfarin pharmacogenetic profile showed that he was warfarin sensitive. This is the first report describing the presence of gene polymorphisms affecting warfarin metabolism in a subject with a biopsy-proven WRN. The patient was treated with corticosteroids obtaining a partial clinical response.
华法林相关肾病（WRN）是华法林治疗的一种肾脏并发症，与抗凝过度有关。我们描述了一例73岁男性患者，患有慢性肾脏病、原发性高血压和心房颤动，接受华法林治疗。该患者在多次抗凝过度发作后出现快速进展的肾衰竭，肾活检显示为WRN。有趣的是，患者的华法林药物遗传学特征显示他对华法林敏感。这是第一份描述在经活检证实为WRN的患者中存在影响华法林代谢的基因多态性的报告。该患者接受了皮质类固醇治疗，获得了部分临床缓解。
