Warfarin-related nephropathy due to excessive anticoagulation induced by combination of warfarin and amiodarone
10.3760/cma.j.cn114015-20230802-00578
- VernacularTitle:华法林与胺碘酮联用致抗凝过度引起华法林相关肾病
- Author:
Caixia FAN
1
;
Dequn GUO
;
Zhengrong LI
;
Guiling SUN
Author Information
1. 临沂市人民医院药学部，临沂 276000
- Publication Type:Journal Article
- Keywords:
Anticoagulants;
Warfarin;
Acute kidney injury;
Warfarin-related nephropathy;
Amiodarone;
Drug interactions
- From:
Adverse Drug Reactions Journal
2024;26(5):318-320
- CountryChina
- Language:Chinese
-
Abstract:
A 49-year-old male patient received long-term use of warfarin 5 mg once daily orally after the operation of aortic mechanical valve replacement, and the international normalized ratio (INR) was maintained at 1.80~2.50. The patient was treated with amiodarone due to atrial tachycardia, and developed nasal bleeding 1 week later. Laboratory tests showed prothrombin time (PT) 79.7 s, INR 10.17, serum creatinine (Scr) 1 032 μmol/L, and blood urea nitrogen (BUN) 29.4 mmol/L; urine routine examination showed urinary occult blood (+) and urinary protein (±). Considering that it was warfarin-related nephropathy caused by the combination of amiodarone, which can enhance the anticoagulant effect of warfarin, leading to excessive anticoagulation. Warfarin was discontinued and the treatments such as local hemostasis, vitamin K 1, tranexamic acid, Bailing capsules (百令胶囊), lanthanum carbonate chewable tablets, and continuous hemodialysis were given. Five days of drug withdrawal, warfarin was restored. Two weeks later, laboratory tests showed PT 21.0 s, INR 1.82, Scr 179 μmol/L, and BUN 19.0 mmol/L. Renal function indicators were within the reference range at 2 and 6 months of follow-up.
