PB0501 - Risk of anticoagulant-related nephropathy early after initiating treatment

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Gregor Tratar, MD, PhD

Physician
University Medical Centre Ljubljana
Ljubljana, Ljubljana, Slovenia

Co-Author(s)

TV

Tjaša Vižintin Cuderman

Physician
University Medical Centre Ljubljana, Department of Vascular Diseases
Ljubljana, Ljubljana, Slovenia
A�

Andrej Škoberne

Physician
University Medical Centre Ljubljana, Department of Nephrology
Ljubljana, Ljubljana, Slovenia
AK

Ana Koželj

Student
University of Ljubljana, Faculty of Medicine
Ljubljana, Ljubljana, Slovenia
VL

Valentina Lapuh

Student
University of Ljubljana, Faculty of Medicine
Ljubljana, Ljubljana, Slovenia
LR

Lea Rozman

Student
University of Ljubljana, Faculty of Medicine
Ljubljana, Ljubljana, Slovenia

Background: Anticoagulant-related nephropathy (ARN) is a potentially serious complication in patients receiving anticoagulant treatment. Retrospective studies indicate that ARN occurs in up to 20 % of patients exposed to supratherapeutic INR when treated with vitamin K antagonists but little is known about ARN in direct oral anticoagulants.

Aims: We wanted to determine the incidence of ARN in patients initiating anticoagulant treatment

Methods: We included consecutive anticoagulant-naive patients referred to our anticoagulation clinic. The trial was approved by the national ethical committee and informed consent was obtained prior to inclusion. The choice of anticoagulant was left to the treating physician. Before initiation of therapy and after 4-6 weeks of treatment, urine and blood samples were collected. We defined ARN as a rise in serum creatinine by at least 27 μmol/L or by at least 50 % after initiation of anticoagulant therapy. We also followed concentration of cystatin C and presence of proteinuria and erythrocyturia as markers of renal damage.

Results: We included 198 consecutive patients. All patients required treatment for atrial fibrillation. Patients received apixaban (57%), rivaroxaban (24%), dabigatran (15%) or warfarin (4%). Results are shown in Table 1. None of the patients developed ARN. The only significant difference was a slight rise in concentration of cystatin C but the absolute difference was negligible.

Conclusion(s): ARN appears to be rare in the first weeks after initiating anticoagulant treatment.