Liječnički vjesnik, Vol. 147 No. 1-2, 2025.
Review article
https://doi.org/10.26800/LV-147-1-2-4
Dabigatran-related nephropathy: a case report and literature review
ADRIANA ADAMOVIĆ
NIKOLA ZAGOREC
orcid.org/0000-0002-6816-5587
*
MATIJA HORAČEK
PETAR ŠANJUG
DANICA GALEŠIĆ LJUBANOVIĆ
KREŠIMIR GALEŠIĆ
IVICA HORVATIĆ
* Corresponding author.
Abstract
Oral anticoagulants can cause acute kidney injury (AKI) called anticoagulant-related nephropathy (ARN) characterized by glomerular hemorrhage and tubular obstruction by red blood cell (RBC) casts. ARN is most
commonly related to warfarin. Recent research showed that non-vitamin K oral anticoagulants (NOACs), such as
dabigatran (DG), can also be related to a similar type of AKI consistent with ARN called DG-related nephropathy.
The vast majority of previously reported cases of DG-related nephropathy included patients with another parenchymal renal disease, most commonly IgA nephropathy (IgAN). Here, we describe a case of kidney biopsy-confirmed DG-related nephropathy in a seventy-five-year-old female patient without evidence of preexisting renal
disease. She has been taking dabigatran due to permanent atrial fibrillation of several years duration. She presented with gross hematuria, severe AKI, clinical and radiological signs of heart failure and skin infection of the
lower limb. Renal biopsy revealed normal glomeruli with signs of moderate to severe acute tubular injury with large intratubular RBC casts and zones of interstitial hemorrhage. Renal function improved significantly after DG
withdrawal. This case demonstrates that DG, like warfarin, may increase the risk of renal tubular bleeding in patients, irrespective of the absence of other parenchymal kidney disease.
Keywords
ACUTE KIDNEY INJURY – chemically induced, pathology, therapy; DABIGATRAN – adverse effects, therapeutic use; ANTICOAGULANTS – adverse effects; ATRIAL FIBRILLATION – drug therapy; KIDNEY – drug effects, pathology; KIDNEY TUBULES – pathology; BIOPSY
Hrčak ID:
328788
URI
Publication date:
10.3.2025.
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