Non-Vitamin K Antagonist Oral Anticoagulants Related Nephropathy
Article Sidebar
Main Article Content
Abstract
Non-vitamin K oral anticoagulants (NOACs) are widely used for various indications, such as stroke prevention in atrial fibrillation. Previous data include numerous case reports of unexplained acute kidney injury associated with NOAC use. Kidney biopsies in these cases have revealed red blood cell obstruction in Bowman’s space and renal tubules. Risk factors for NOACs-related nephropathy include underlying chronic kidney disease, diabetes mellitus, hypertension, and pre-existing IgA nephropathy. A kidney biopsy is recommended to confirm the diagnosis in patients suspected of having NOACs-related nephropathy. The primary treatment is supportive care, which may include temporarily discontinuing the medication. In cases where supportive care alone is insufficient, additional treatments such as corticosteroids or NOAC-specific antidotes have been reported to provide some benefits.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This article is published under CC BY-NC-ND 4.0 license, which allows for non-commercial reuse of the published paper as long as the published paper is fully attributed. Anyone can share (copy and redistribute) the material in any medium or format without having to ask permission from the author or the Nephrology Society of Thailand.
References
Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomstrom-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373-498.
Yeh CH, Hogg K, Weitz JI. Overview of the new oral anticoagulants: opportunities and challenges. Arterioscler Thromb Vasc Biol. 2015;35(5):1056-65.
Chen A, Stecker E, B AW. Direct Oral Anticoagulant Use: A Practical Guide to Common Clinical Challenges. J Am Heart Assoc. 2020;9(13):e017559.
Chen S, Liao D, Yang M, Wang S. Anticoagulant-related nephropathy induced by direct-acting oral anticoagulants:Clinical characteristics, treatments and outcomes. Thromb Res. 2023;222:20-3.
Sharfuddin N, Nourbakhsh M, Box A, Benediktsson H, Muruve DA. Anticoagulant Related Nephropathy Induced by Dabigatran. Case Rep Nephrol. 2018;2018:7381505.
Brodsky SV, Mhaskar NS, Thiruveedi S, Dhingra R, Reuben SC, Calomeni E, et al. Acute kidney injury aggravated by treatment initiation with apixaban: Another twist of anticoagulant-related nephropathy. Kidney Res Clin Pract. 2017;36(4):387-92.
Trujillo H, Sandino J, Cavero T, Caravaca-Fontan F, Gutierrez E, Sevillano AM, et al. IgA Nephropathy Is the Most Common Underlying Disease in Patients With Anticoagulant-Related Nephropathy. Kidney Int Rep. 2022;7(4):831-40.
Aursulesei V, Costache, II. Anticoagulation in chronic kidney disease: from guidelines to clinical practice. Clin Cardiol. 2019;42(8):774-82.
Paul C, Baby M, Anthraper AR, K K. NOACs: an emerging class of oral anticoagulants-a review article. Future Journal of Pharmaceutical Sciences. 2020;6(1).
Brodsky SV, Satoskar A, Chen J, Nadasdy G, Eagen JW, Hamirani M, et al. Acute kidney injury during warfarin therapy associated with obstructive tubular red blood cell casts: a report of 9 cases. Am J Kidney Dis. 2009;54(6):1121-6.
Oliveira M, Lima C, Góis M, Viana H, Carvalho F, Lemos S. Rivaroxaban-related nephropathy. Port J Nephrol Hypert 2017;31(3): 212-216
Wheeler DS, Giugliano RP, Rangaswami J. Anticoagulationrelated nephropathy. J Thromb Haemost. 2016;14(3):461-7.
Brodsky SV, Collins M, Park E, Rovin BH, Satoskar AA, Nadasdy G, et al. Warfarin therapy that results in an International Normalization Ratio above the therapeutic range is associated with accelerated progression of chronic kidney disease. Nephron Clin Pract. 2010;115(2):c142-6.
Chan YH, Yeh YH, See LC, Wang CL, Chang SH, Lee HF, et al. Acute Kidney Injury in Asians With Atrial Fibrillation Treated With Dabigatran or Warfarin. J Am Coll Cardiol. 2016;68(21):2272-83.
Alsamarrai A, Eaddy N, Curry E. Idarucizumab for the treatment of dabigatran-related nephropathy. Clin Kidney J. 2021;14(2):710-1.
Belcic Mikic T, Kojc N, Frelih M, Ales-Rigler A, Veceric-Haler Z. Management of Anticoagulant-Related Nephropathy: A Single Center Experience. J Clin Med. 2021;10(4).