Anticoagulant-related nephropathy: a clinical risk to be vigilant
10.3760/cma.j.cn114015-20241023-00112
- VernacularTitle:抗凝药物相关肾病：临床需警惕的风险
- Author:
Jinhua ZHANG
1
;
Peiguang NIU
1
Author Information
1. 福建省妇幼保健院药学部，福州 350001
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
Anticoagulants;
Warfarin;
Anticoagulant-related nephropathy;
Direct oral anticoagulants
- From:
Adverse Drug Reactions Journal
2025;27(1):2-5
- CountryChina
- Language:Chinese
-
Abstract:
With the aging of the population and the increasing number of patients with thromboembolic diseases, oral anticoagulants are more and more widely used. Anticoagulant-related nephropathy (ARN) is a significant adverse reaction in the treatment with oral anticoagulants, generally considered to be a form of acute kidney injury caused by excessive anticoagulation. The mechanisms involved may include glomerular hemorrhage, obstruction of renal tubules by red cell casts, and damage to tubular epithelial cells. Abnormalities in coagulation function and renal function are the main risk factors for ARN; older age, diabetes mellitus, and cardiovascular diseases such as hypertension and heart failure also increase the risk of ARN occurrence. ARN should be managed based on individual patient characteristics. Benefits and risks of treatment should be carefully considered when choosing oral anticoagulants; renal function should be closely monitored during treatments to detect potential risks early. In case of ARN, it is advised to promptly adjust the anticoagulant therapy and provide symptomatic supportive treatments. In severe cases, treatments with methylprednisolone combined with hemodialysis can be employed.
