IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy.

IgA nephropathy acute kidney injury anticoagulation hematuria kidney biopsy

Journal

Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 13 11 2021
revised: 10 01 2022
accepted: 10 01 2022
entrez: 2 5 2022
pubmed: 3 5 2022
medline: 3 5 2022
Statut: epublish

Résumé

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. 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. 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. 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.

Identifiants

pubmed: 35497792
doi: 10.1016/j.ekir.2022.01.1048
pii: S2468-0249(22)01050-6
pmc: PMC9039479
doi:

Types de publication

Journal Article

Langues

eng

Pagination

831-840

Informations de copyright

© 2022 International Society of Nephrology. Published by Elsevier Inc.

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Auteurs

Hernando Trujillo (H)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Justo Sandino (J)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Teresa Cavero (T)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Fernando Caravaca-Fontán (F)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Instituto de Investigación del Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.

Eduardo Gutiérrez (E)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Ángel M Sevillano (ÁM)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Amir Shabaka (A)

Department of Nephrology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Gema Fernández-Juárez (G)

Department of Nephrology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Pablo Rodríguez Doyágüez (P)

Department of Nephrology, Hospital Universitario Príncipe de Asturias de Alcalá de Henares, Madrid, Spain.

Rocío Gimena Muñoz (R)

Department of Nephrology, Hospital Universitario Príncipe de Asturias de Alcalá de Henares, Madrid, Spain.

Leonardo Calle García (L)

Department of Nephrology, Complejo Asistencial de Segovia, Segovia, Spain.

Virginia Cabello (V)

Department of Nephrology, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

José Manuel Muñoz-Terol (JM)

Department of Nephrology, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

Ana García Santiago (A)

Department of Nephrology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Oscar Toldos (O)

Department of Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Juan Antonio Moreno (JA)

Department of Cell Biology, Physiology and Immunology, University of Cordoba, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), UGC Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.

Manuel Praga (M)

Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Instituto de Investigación del Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.
Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain.

Classifications MeSH