Dabigatran-Related Nephropathy in a Patient with Undiagnosed IgA Nephropathy.
Dabigatran is a direct thrombin inhibitor used as an alternative to warfarin for long term anticoagulation. Warfarin-related nephropathy is an increasingly recognized entity, but recent evidence suggests that dabigatran can cause a WRN-like syndrome. We describe a case of a biopsy-proven anticoagulant nephropathy related to dabigatran in a patient with IgA nephropathy and propose that, despite the base glomerular disease, acute kidney injury was due to tubular obstruction by red blood cells and heme-associated tubular injury, and through a mechanism involving inhibition of anticoagulation cascade and barrier abnormalities caused by molecular mechanisms.
Department of Nephrology, Centro Hospitalar do Médio Tejo, 2350-754 Torres Novas, Portugal.
Rachele
R
Escoli
Department of Nephrology, Centro Hospitalar do Médio Tejo, 2350-754 Torres Novas, Portugal.
Paulo
P
Santos
Department of Nephrology, Centro Hospitalar do Médio Tejo, 2350-754 Torres Novas, Portugal.
Sequeira
S
Andrade
Department of Nephrology, Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, 1069-166 Lisbon, Portugal.
Fernanda
F
Carvalho