Why the study?
Spontaneous perinephric hematoma is an uncommon but serious condition typically caused by tumor hemorrhage or vascular disease.
Concurrent use of rivaroxaban and clopidogrel in patients with underlying renal disease may increase the risk of spontaneous perinephric hematoma.
Spontaneous perinephric hematoma may occur with rivaroxaban plus clopidogrel in CKD; this Level 5 case leaves open causal links and practice implications.
Spontaneous perinephric hematoma is an uncommon but serious condition that is typically caused by tumor hemorrhage or vascular disease such as polyarteritis nodosa. We describe a 78-year-old Chinese gentleman with underlying chronic kidney disease, renal cysts, non-obstructive renal stones, hypertension, ischemic heart disease, and atrial fibrillation who was on rivaroxaban and clopidogrel. He developed spontaneous perinephric hematoma complicated by acute kidney injury, anemia, and myocardial infarction who underwent angioembolization and packed cell transfusion. He did not have further bleeding episodes, and his kidney function improved before discharge.
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Lee et al. (2022) studied this question.
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