ARN – anticoagulant related nephropathy: Lessons from patients and experimental animals

Journal of Nephrology & Therapeutics

ISSN: 2161-0959

Open Access

ARN – anticoagulant related nephropathy: Lessons from patients and experimental animals

5th Global Nephrologists Annual Meeting

March 31-April 02, 2016 Valencia, Spain

Sergey V Brodsky

The Ohio State University, USA

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

We have recently identified a new clinical syndrome in patients receiving warfarin for anticoagulation. This syndrome has been named warfarin-related nephropathy (WRN) and patients with Chronic Kidney Disease (CKD) appear to be particularly susceptible. WRN is defined as an acute increase in INR to greater than 3.0, followed by evidence of Acute Kidney Injury (AKI) within a week of the INR increase, defined as a sustained increase in serum creatinine of greater than or equal to 0.3 mg/dl. The AKI cannot be explained by any other factors and the kidney biopsy demonstrates extensive glomerular hemorrhage with tubular obstruction by red blood cells. Beyond AKI, WRN is a significant risk factor for mortality within the first two months of diagnosis and it accelerates the progression of CKD. CKD is the most important risk factor for WRN and in CKD patients on warfarin who experience an increase in INR to >3.0, WRN is seen in 33â??37% of the patients. Recent evidences suggest that WRN-like syndromes are not confined to anti-coagulation with warfarin, but may be seen with the newer oral anticoagulants coming into clinical use. We have thus coined the term Anticoagulant-Related Nephropathy (ARN) to encompass the possibility that other anticoagulant drugs may put patients at risk. We developed an animal model to study ARN. 5/6 nephrectomy rats treated with warfarin or dabigatran showed increase in serum creatinine and morphology in the kidney similar to humans. Nephrologists and renal pathologists should be aware about this serious complication of anticogulation therapy.

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