Abdulhadi Basma, Mulki Ramzi, Goyal Abhinav, Rangaswami Janani
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2017 Aug 28;2017:bcr-2017-221641. doi: 10.1136/bcr-2017-221641.
Non-vitamin K oral anticoagulants (NOACs) are being increasingly prescribed. These drugs act rapidly, have predictable dose-related anticoagulation effect and require no routine laboratory monitoring, making them attractive for both patients and healthcare providers. All NOACs are at least partially excreted thought the kidneys. Renal injury related to NOAC use is being increasingly reported. NOAC-related acute interstitial nephritis (AIN) has only been reported once and that was in context of dabigatran use. We describe the first case of apixaban-related AIN. This case adds an important differential diagnoses that should be considered for any patient presenting with renal injury while being treated with NOACs.
非维生素K口服抗凝药（NOACs）的处方量越来越大。这些药物起效迅速，具有可预测的剂量相关抗凝作用，且无需常规实验室监测，这使得它们对患者和医疗服务提供者都颇具吸引力。所有NOACs至少部分通过肾脏排泄。与使用NOACs相关的肾损伤报告越来越多。与NOACs相关的急性间质性肾炎（AIN）仅被报告过一次，且是在使用达比加群的情况下。我们描述了首例与阿哌沙班相关的AIN病例。该病例增加了一个重要的鉴别诊断，对于任何在接受NOACs治疗时出现肾损伤的患者都应予以考虑。
