20.500.12556/RUL-135058 Management of anticoagulant-related nephropathy a single center experience Background: Anticoagulant-related nephropathy (ARN) is a form of acute kidney injury that mainly occurs in patients with previously unrecognized glomerular disease in addition to excessive anticoagulation. Since a renal biopsy is not performed in most cases, the diagnosis is often presumptive. Methods: Here, we present the characteristics of a national Slovenian patient cohort with histologically verified ARN, from the first case in 2014 to December 2020, and a review of the current literature (Pubmed database). Results: In Slovenia, ARN has been detected in 13 patients, seven of whom were treated with coumarins, and others with direct oral anticoagulants. In seven patients, ARN appeared after excessive anticoagulation. As many as 11 patients had underlying IgA nephropathy. Similar to the global data presented here, the pathohistological impairment associated with pre-existing glomerulopathy was mild and disproportionate to the degree of functional renal impairment. The majority of our patients with ARN experienced severe deterioration of renal function associated with histological signs of accompanying acute tubular injury, interstitial edema, and occlusive red blood cell casts. These patients were treated with corticosteroids, which (in addition to supportive treatment and discontinuation of the anticoagulant drug) led to a further improvement in renal function. Conclusions: Anticoagulant therapy combined with a pre-existing glomerular injury may lead to ARN. In addition to discontinuation of the anticoagulant and supportive care, corticosteroids, which are currently listed in only a few cases in the world literature, may have a positive influence on the course of treatment. However, the benefits of steroid treatment must be weighed against the risk of complications, especially life-threatening infections. anticoagulant related nephropathy ARN warfarin nephropathy anticoagulant kidney disease glomerular hemorrhage anticoagulants DOACs NOACs true false true Angleški jezik Ni določen Članek v reviji 2022-02-18 15:17:06 2022-02-18 15:17:07 2022-09-14 04:11:26 0000-00-00 00:00:00 2021 0 0 16 str. iss. 4, art. 796 Vol. 10 2021 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.6 2077-0383 10.3390/jcm10040796 52949763 RAZ_Belcic_Tanja_2021.pdf RAZ_Belcic_Tanja_2021.pdf 1 22F4B3F007F72A1643D84EBF39E2B34E b56a2c85fed8e2ac4a9190444f6da06dfc6bbd478e728733e4294ef13422f47f bd81bda1-90c5-11ec-abdb-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=153905 https://www.mdpi.com/2077-0383/10/4/796 1 356f0e41-90c5-11ec-abdb-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=153904 Medicinska fakulteta 0 0 0