Warfarin-Related Nephropathy: Unveiling the Hidden Dangers of Anticoagulation

Abstract

Abstract Warfarin-related nephropathy (WRN) is defined as acute kidney injury (AKI) subsequent to excessive anticoagulation with warfarin. Patients with mechanical prosthetic valves required long-term anticoagulant therapy, and warfarin remains the sole available option for anticoagulant therapy. Consequently, patients with mechanical prosthetic valves constitute a special group among the entire anticoagulant population. The present study recorded two cases in which patients who had undergone mechanical prosthetic valve surgery and were receiving warfarin therapy presented to the hospital with gross hematuria and progressive creatinine levels. Notably, the international normalized ratio (INR) did not exceed 3 in these two patients. Subsequent renal biopsies confirmed the presence of WRN with IgA nephropathy. The two patients continued to receive anticoagulation with warfarin and were prescribed oral corticosteroids and cyclophosphamide, which resulted in improved renal function during the follow period. Based on a review of all relevant literature and the present study, we also pose a new challenge, whether elevated INR levels must be as one of the criteria for clinical diagnosis of WRN? Perhaps it can get some inspiration from the present article.