Anticoagulant-related nephropathy caused by enoxaparin: a case report and literature review

VernacularTitle:依诺肝素致抗凝剂相关肾病1例及文献复习
Author: Juanli WANG ¹ ; Wei LIU ; Ya WANG ; Wenjun ZHANG ; Yuke KONG ; Jianqin WANG ; Yindi WANG
Author Information

1. 兰州大学第二医院肾内科，兰州　730030
Publication Type:Journal Article
Keywords: Anticoagulants; Kidney diseases; Enoxaparin; Acute kidney injury
From: Chinese Journal of Nephrology 2025;41(5):376-379
CountryChina
Language:Chinese
Abstract: This paper presents a rare renal biopsy-confirmed case of enoxaparin-induced anticoagulant-related nephropathy (ARN). A 62-year-old male was admitted with microscopic hematuria, massive albuminuria, and elevated serum creatinine following postoperative right shoulder joint infection. The serum creatinine level decreased after surgical debridement and antibiotic therapy. Enoxaparin (4 000 U daily) was initiated for thromboembolism prevention. The patient developed acute kidney injury with serum creatinine 517 μmol/L accompanied by gross hematuria. Renal biopsy revealed characteristic features of ARN coexisting with infection-related glomerulonephritis. After antibiotic therapy, urinary alkalinization, hemodialysis, and glucocorticoids (prednisone acetate 30 mg daily) of therapeutic interventions, the renal function partially recovered with dialysis discontinuation. The paper reviews the relevant literature on the risk factors, clinical manifestations, pathological features, diagnosis and treatment of ARN to improve clinicians' understanding.