Key result
Severe hematuria in a patient with underlying IgA nephropathy treated with dabigatran and aspirin led to acute kidney injury due to heme-associated tubular injury.
Case Report (n=1)
Severe hematuria in patients with underlying glomerular pathology treated with dabigatran or warfarin may lead to toxic tubular injury and acute kidney injury.
Answers are grounded in this paper and cite their sources.
May trigger heme-induced AKI in anticoagulated IgA nephropathy; hypothesis-generating case report needing prospective confirmation.
Dabigatran is a direct thrombin inhibitor used as an alternative to warfarin for long-term anticoagulation. We describe a patient who developed acute kidney injury (AKI) in the setting of warfarin conversion to dabigatran, and a renal biopsy demonstrating acute tubular injury. Although the patient had undiagnosed IgA nephropathy that may have predisposed him to bleeding, AKI was due to heme-associated tubular injury. We propose that severe hematuria in patients with underlying glomerular pathology treated with either dabigatran or warfarin may lead to toxic tubular injury through the accumulation of heme-proteins.
No takes yet. Share an insight, caveat, or question.
Moeckel et al. (2013) conducted a case report in Acute kidney injury and IgA nephropathy (n=1). Dabigatran and aspirin was evaluated on Acute kidney injury due to heme-associated tubular injury. Severe hematuria in a patient with underlying IgA nephropathy treated with dabigatran and aspirin led to acute kidney injury due to heme-associated tubular injury.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: