This is the first report describing gene polymorphisms affecting warfarin metabolism in a patient with biopsy-proven warfarin-related nephropathy.
Warfarin sensitivity genotypes may predispose to biopsy-proven nephropathy; single case leaves open whether pharmacogenetic testing alters outcomes.
Warfarin-related nephropathy (WRN) is a renal complication of warfarin treatment associated with over-anticoagulation. We describe a case of a 73-year-old man affected by chronic kidney disease, essential hypertension and atrial fibrillation treated with warfarin. The patient presented a rapid course of kidney failure after many episodes of over-anticoagulation, and renal biopsy demonstrated WRN. Interestingly, the patient's warfarin pharmacogenetic profile showed that he was warfarin sensitive. This is the first report describing the presence of gene polymorphisms affecting warfarin metabolism in a subject with a biopsy-proven WRN. The patient was treated with corticosteroids obtaining a partial clinical response.
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Maso et al. (2014) studied this question.
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