Artículo
IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy
Autor/es | Trujillo, H.
Sandino, J. Cavero, Teresa Caravaca-Fontan, F Gutierrez, E. Sevillano, A.M. Muñoz Terol, José Manuel Praga, Manuel |
Departamento | Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2022-01-19 |
Fecha de depósito | 2023-05-16 |
Publicado en |
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Resumen | Introduction
Anticoagulant-related nephropathy (ARN) is a relatively novel recognized entity characterized by hematuria-associated acute kidney injury (AKI) in the context of overanticoagulation. Preexisting or underlying ... Introduction Anticoagulant-related nephropathy (ARN) is a relatively novel recognized entity characterized by hematuria-associated acute kidney injury (AKI) in the context of overanticoagulation. Preexisting or underlying kidney disease seems to be a predisposing factor; however, few studies have described histologic findings in patients with ARN. We aimed to evaluate underlying kidney pathology in patients on oral anticoagulation who presented an episode of AKI with hematuria in whom a kidney biopsy was performed. Methods Retrospective observational multicenter case study in patients treated with oral anticoagulants who developed macroscopic or intense hematuria followed by AKI. Only patients with available kidney biopsy specimens were included. Histologic findings and clinical data throughout follow-up were analyzed. Results A total of 26 patients were included with a median age of 75 years (62–80) and a follow-up period of 10.1 months. Of the patients, 80% were male, and most cases (92%) were on anticoagulation with vitamin K antagonists (VKAs). At admission, median serum creatinine (SCr) level was 4.2 mg/dl (2.8–8.2), median international normalized ratio (INR) 2.4 (1.5–3.4), and 11 patients (42%) required acute dialysis during hospitalization. Kidney biopsy results revealed that all patients except 1 had an underlying nephropathy: IgA nephropathy (IgAN) in 19, probable IgAN in 1, diabetic nephropathy in 3, nephrosclerosis in 1, and idiopathic nodular glomerulosclerosis in 1. At 12 weeks after discharge, only 6 subjects (24%) attained complete kidney recovery whereas 7 (28%) remained on chronic dialysis. Conclusion IgAN was the most common underlying kidney disease in our biopsy-proven series of ARN, in which a significant percentage of patients did not achieve kidney function recovery. |
Agencias financiadoras | Comunidad Autónoma de Madrid Consejería de Salud y Familias. Junta de Andalucía Instituto de Salud Carlos III Red de Investigacion Renal (RedInRen) Centro Español de Investigación Biomédica en Enfermedades Cardiovasculares (CIBERCV) Ministerio de Ciencia e Innovación (MICIN). España Sociedad Española de Nefrología (SEN) |
Identificador del proyecto | S2017/BMD-3673
PI17/00130 PI20/00375 PI16/01685 PI19/01624 PIGE-0052-2020 RD12/0021/0029 RETYC 16/009/009 RD12/0021/0029 RYC2017-22369 |
Cita | Trujillo, H., Sandino, J., Cavero, T., Caravaca-Fontan, F., Gutierrez, E., Sevillano, A.M.,...,Praga, M. (2022). IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy. Kidney International Reports, 7 (4), 831-840. https://doi.org/10.1016/j.ekir.2022.01.1048. |
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