Subject(s)
Humans , Male , Aged , Thrombosis , Nephrotic Syndrome/complications , Antithrombins , Thrombophilia , HypertensionABSTRACT
Introduction: Anticoagulant-related nephropathy (ARN) is a relatively novel recognized entity characterized by hematuria-associated acute kidney injury (AKI) in the context of overanticoagulation. Preexisting or underlying kidney disease seems to be a predisposing factor; however, few studies have described histologic findings in patients with ARN. We aimed to evaluate underlying kidney pathology in patients on oral anticoagulation who presented an episode of AKI with hematuria in whom a kidney biopsy was performed. Methods: Retrospective observational multicenter case study in patients treated with oral anticoagulants who developed macroscopic or intense hematuria followed by AKI. Only patients with available kidney biopsy specimens were included. Histologic findings and clinical data throughout follow-up were analyzed. Results: A total of 26 patients were included with a median age of 75 years (62-80) and a follow-up period of 10.1 months. Of the patients, 80% were male, and most cases (92%) were on anticoagulation with vitamin K antagonists (VKAs). At admission, median serum creatinine (SCr) level was 4.2 mg/dl (2.8-8.2), median international normalized ratio (INR) 2.4 (1.5-3.4), and 11 patients (42%) required acute dialysis during hospitalization. Kidney biopsy results revealed that all patients except 1 had an underlying nephropathy: IgA nephropathy (IgAN) in 19, probable IgAN in 1, diabetic nephropathy in 3, nephrosclerosis in 1, and idiopathic nodular glomerulosclerosis in 1. At 12 weeks after discharge, only 6 subjects (24%) attained complete kidney recovery whereas 7 (28%) remained on chronic dialysis. Conclusion: IgAN was the most common underlying kidney disease in our biopsy-proven series of ARN, in which a significant percentage of patients did not achieve kidney function recovery.
ABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Renal Insufficiency, Chronic/surgery , Renal Insufficiency, Chronic/therapy , Kidney Transplantation/adverse effects , Renal Dialysis , Virus Activation , Hepatitis B , Hepatitis B virus/physiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Neoplasms/epidemiology , Renal Insufficiency, Chronic/epidemiology , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Comorbidity , Cross-Sectional Studies , Medical Oncology/trends , Neoplasms/blood , Neoplasms/drug therapy , Nephrology/trends , Outpatients/statistics & numerical data , Prevalence , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/chemically induced , Renal Insufficiency, Chronic/diagnostic imaging , Spain/epidemiology , Tomography, X-Ray ComputedSubject(s)
Neoplasms/epidemiology , Renal Insufficiency, Chronic/epidemiology , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Medical Oncology/trends , Middle Aged , Neoplasms/blood , Neoplasms/drug therapy , Nephrology/trends , Outpatients/statistics & numerical data , Prevalence , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/chemically induced , Renal Insufficiency, Chronic/diagnostic imaging , Spain/epidemiology , Tomography, X-Ray Computed , Young AdultSubject(s)
Hepatitis B virus/physiology , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Kidney Transplantation , Postoperative Complications/diagnosis , Postoperative Complications/prevention & control , Virus Activation , Humans , Male , Middle Aged , Postoperative Complications/virology , Renal DialysisABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Cathartics/administration & dosage , Cathartics/adverse effects , Kidney Diseases/chemically induced , Kidney Diseases/diagnosis , Phosphates/adverse effects , Administration, Oral , Colonoscopy , Phosphates/administration & dosage , Preoperative CareSubject(s)
Cathartics/adverse effects , Colonoscopy , Kidney Diseases/chemically induced , Phosphates/adverse effects , Administration, Oral , Aged , Aged, 80 and over , Cathartics/administration & dosage , Female , Humans , Kidney Diseases/diagnosis , Male , Middle Aged , Phosphates/administration & dosage , Preoperative CareABSTRACT
Describimos el caso de una mujer joven, que fue diagnosticada de insuficiencia renal avanzada, con un hallazgo casual de una nefrocalcinosis sin una etiología clara, al haberse encontrado asintomática a lo largo de su vida. El estudio genético por paneles de genes conocidos asociados a enfermedad tubulointersticial permitió descubrir una acidosis tubular renal distal autosómica dominante, asociada a una mutación de novo en el exón 14 del gen SLC4A1, que hubiera sido imposible diagnosticar clínicamente por lo avanzado de la enfermedad renal cuando fue descubierta (AU)
We describe the case of a young woman who was diagnosed with advanced kidney disease, with an incidental finding of nephrocalcinosis of unknown aetiology, having been found asymptomatic throughout her life. The genetic study by panels of known genes associated with tubulointerstitial disease allowed us to discover autosomal dominant distal renal tubular acidosis associated with a de novo mutation in exon 14 of the SLC4A1 gene, which would have been impossible to diagnose clinically due to the advanced nature of the kidney disease when it was discovered (AU)
Subject(s)
Humans , Female , Adult , Acidosis, Renal Tubular/genetics , Genetic Testing/methods , Renal Insufficiency, Chronic/genetics , Nephrocalcinosis/genetics , Genetic Markers , Genetic Predisposition to DiseaseABSTRACT
We describe the case of a young woman who was diagnosed with advanced kidney disease, with an incidental finding of nephrocalcinosis of unknown aetiology, having been found asymptomatic throughout her life. The genetic study by panels of known genes associated with tubulointerstitial disease allowed us to discover autosomal dominant distal renal tubular acidosis associated with a de novo mutation in exon 14 of the SLC4A1 gene, which would have been impossible to diagnose clinically due to the advanced nature of the kidney disease when it was discovered.
Subject(s)
Acidosis, Renal Tubular/diagnosis , Acidosis, Renal Tubular/genetics , Anion Exchange Protein 1, Erythrocyte/genetics , Adult , Exons , Female , Humans , Kidney/physiopathology , Mutation , Nephrocalcinosis/etiologyABSTRACT
No disponible