Key result
Resumption of dabigatran therapy in an 81-year-old man with chronic kidney disease led to gross hematuria and acute kidney injury revealing undiagnosed immunoglobulin A nephropathy.
Case Report (n=1)
No
This case highlights a potential safety signal where dabigatran therapy may precipitate acute kidney injury and hematuria in patients with undiagnosed immunoglobulin A nephropathy.
Answers are grounded in this paper and cite their sources.
Dabigatran resumption may trigger IgA nephropathy; leaves open causality and requires confirmation in larger cohorts.
Dabigatran, a new oral anticoagulant, is a direct thrombin inhibitor used as an alternative to warfarin to reduce the risk of stroke and systemic embolism with nonvalvular atrial fibrillation. We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. With discontinuation of dabigatran and addition of methylprednisolone, the gross hematuria cleared and urine output improved.
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Jansky et al. (2018) conducted a case report in Acute kidney injury and immunoglobulin A nephropathy (n=1). Dabigatran was evaluated on Development of acute kidney injury and gross hematuria. Resumption of dabigatran therapy in an 81-year-old man with chronic kidney disease led to gross hematuria and acute kidney injury revealing undiagnosed immunoglobulin A nephropathy.
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