Key result
A 33-year-old male with mechanical heart valves on warfarin developed acute kidney injury caused by concurrent pigment nephropathy and warfarin-related nephropathy.
Case Report (n=1)
No
Patients with mechanical heart valves on warfarin can develop acute kidney injury due to a combination of shear stress-related pigment nephropathy and warfarin-related nephropathy.
Alerts clinicians to concurrent pigment and warfarin-related nephropathy in AKI; hypothesis-generating and leaves optimal management open.
It is well known that patients with mechanical heart valves may develop sheer stress related hemolysis and consequent pigment related nephropathy. Warfarin Related Nephropathy (WRN) is a relatively new entity and defined as Acute Kidney Injury (AKI) in the setting of an INR of > 3.0 excluding other obvious etiologies. A biopsy diagnosis of WRN is conducted when red blood cell casts are noted filling and blocking the tubules; additionally, glomerular hemorrhage may be observed. We describe a patient with mechanical heart valves on oral anticoagulation who developed both pigment nephropathy and WRN causing AKI.
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Conjeevaram et al. (2019) conducted a case report in Acute Kidney Injury (n=1). Warfarin was evaluated on Development of Acute Kidney Injury. A 33-year-old male with mechanical heart valves on warfarin developed acute kidney injury caused by concurrent pigment nephropathy and warfarin-related nephropathy.
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