Why the study?
Direct oral anticoagulants and vitamin K antagonists are both recognized causes of anticoagulant related nephropathy.
Rivaroxaban can cause anticoagulant-related nephropathy, emphasizing the need for careful monitoring of serum creatinine in patients taking DOACs, especially those with pre-existing CKD.
ARN may occur with rivaroxaban in CKD patients with AKI; this case leaves open comparative DOAC risks and warrants prospective study.
The characteristics of direct oral anticoagulants (DOACs) make them more appealing for prevention of thromboembolic events than vitamin K antagonists (VKA). Despite that, both classes have been a recognized as a cause of anticoagulant related nephropathy (ARN). Herein we describe a case of a 72-year-old man, with chronic kidney disease (CKD), medicated with rivaroxaban, who presented with acute kidney injury (AKI) and microscopic hematuria. The kidney biopsy revealed anticoagulant related-nephropathy. Rivaroxaban was suspended, the patient showed improvement of renal function and apixaban was prescribed. This case emphasizes the need for careful monitoring of serum creatinine when these drugs are prescribed, especially in high risk groups.
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Costa et al. (2022) studied this question.
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