title: [Case report: end stage renal disease in a chronic kidney patient on warfarin therapy].
abstract: BACKGROUND
  Warfarin therapy can provoke severe hematuria and acute kidney injury with the presence of occlusive red blood cell casts. These findings are compatible with a recently described disease entity, warfarin related nephropathy, which adversely affects renal and patient outcome.
  
  
  METHODS
  We report a 74-year-old man with chronic kidney disease stage 3 A, who developed a decline in glomerular filtration rate (GFR) after the initiation of warfarin therapy due to of atrial fibrillation. The diagnosis could be confirmed by renal histology which showed occlusion of renal tubules by red blood cells and casts consistent with this diagnosis. The patient did not recover the GFR and started renal replacement therapy in June (fourteen months after starting warfarin) 2014.
  
  
  CONCLUSIONS
  The aim of the present report is to alert for this drug recognized complication and reinforce the need of carefully motorization of kidney function and coagulation parameters in patients treated with warfarin. The pathogenesis and outcome of warfarin-related nephropathy is also discussed here.
authors.affiliation: Serviço de Nefrologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, Portugal.
authors.forename: Claudia Patricia Quiterio
authors.initials: CP
authors.lastname: Bento
authors.affiliation: Departamento de Patologia clínica, Universidade Federal do Paraná, Brazil.
authors.forename: Maria
authors.initials: M
authors.lastname: Soares
authors.affiliation: Hospital Universitário Evangélico de Curitiba, Brazil.
authors.forename: Christine
authors.initials: C
authors.lastname: Molin
authors.affiliation: Hospital Universitário Evangélico de Curitiba, Brazil.
authors.forename: Luis
authors.initials: L
authors.lastname: Martins
authors.affiliation: Hospital Universitário Evangélico de Curitiba, Brazil.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Martins
authors.affiliation: Hospital Universitário Evangélico de Curitiba, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Mazza
authors.affiliation: Hospital Universitário Evangélico de Curitiba, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Riella
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D014859:Warfarin