Mayo Clinic, Rochester, MN, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231159978. doi: 10.1177/21501319231159978.
Anticoagulant-related nephropathy (ARN) is a rare, newly recognized cause of acute kidney injury and significant but underdiagnosed complication of anticoagulation therapy. ARN occurs in patients taking oral anticoagulant therapy most often warfarin or a novel oral anticoagulant (NOAC). It is a potentially devastating disorder with serious renal consequences and increased all-cause mortality. Anticoagulant-related nephropathy presents as an acute kidney injury (AKI) in the setting of a supratherapeutic INR with profuse glomerular hemorrhage seen as renal tubules filled with red cells and red cell casts on renal biopsy. Being that millions of Americans are on warfarin, a thorough understanding and awareness of the clinical presentation, diagnosis, and therapeutic interventions are crucial to protecting the renal function, lowering all-cause mortality and optimizing treatment. Our goal is to provide education on a newly recognized form of AKI and significant but underdiagnosed complication of anticoagulation therapy.
抗凝相关肾病 (ARN) 是一种罕见的、新发现的急性肾损伤原因，也是抗凝治疗中严重但未被充分诊断的并发症。ARN 发生在接受口服抗凝治疗的患者中，最常见的是华法林或新型口服抗凝剂 (NOAC)。这是一种潜在的破坏性疾病，具有严重的肾脏后果和全因死亡率增加。抗凝相关肾病在 INR 高于治疗范围的情况下表现为急性肾损伤 (AKI)，大量肾小球出血，肾活检显示肾小管充满红细胞和红细胞管型。鉴于数百万美国人正在服用华法林，因此，彻底了解和认识其临床表现、诊断和治疗干预措施对于保护肾功能、降低全因死亡率和优化治疗至关重要。我们的目标是提供关于一种新发现的 AKI 形式和抗凝治疗中严重但未被充分诊断的并发症的教育。
