acenocoumarol and Glomerulonephritis--IGA

Anticoagulant-related nephropathy is a type of acute kidney injury caused by overcoagulation. We describe a case of an 84-year-old man with arterial hypertension, coronary heart disease and atrial fibrillation treated with acenocoumarol, who presented with haematoproteinuria and acute kidney injury during a phase of excessive anticoagulation. In addition to IgA nephropathy, renal biopsy also revealed acute tubular necrosis, red blood cell casts and positive iron staining in tubular cells. After this acute episode, renal function improved and proteinuria decreased below the nephrotic range.

Topics: Acenocoumarol; Acute Kidney Injury; Aged, 80 and over; Anticoagulants; Glomerulonephritis, IGA; Humans; Kidney Tubular Necrosis, Acute; Male

Forty seven patients with IgA glomerulonephritis (GN) were studied. The males predominated among them--the ratio males-female--2,9:1. The first clinical manifestations were macroscopic hematuria (in 2/3 of the cases) or only urine changes--low-degree proteinuria and microscopic erythrocyturia. As early as the establishment--38,2 per cent of the patients had elevated arterial pressure, and it reached, 59,5 per cent during the follow-up period. Anemia was rare. Manifestations of nephrotic syndrome were absent. ESR was normal in 1/3 of the employees or slightly accelerated. Chronic renal insufficiency developed 6,31 per cent of the patient all of them males. Terminal renal insufficiency developed 8 patients. The elevated arterial pressure, proteinuria over 2g/24 h, accelerated ESR, high serum levels of IgA, the longer duration of the disease and higher age of the patients to a certain extent--were unfavourable prognostic criteria. The basic immune deviations of IgA GN are the high serum levels of IgA (in 53,1% of the patients) and to a lower extent of IgG (in 17% of the patients) as well as the reduced serum levels of C3 (in 31,9% of the patients). CIC are not a frequent finding. The percentage of ERF is lower than in the healthy subjects. The treatment with a combination of azathioprine (acenocoumarol, indomethacin or levamisole) has no effect on the clinical manifestations and evolution.

Topics: Acenocoumarol; Adolescent; Adult; Antigen-Antibody Complex; Azathioprine; Chronic Disease; Complement C3; Drug Therapy, Combination; Female; Glomerulonephritis, IGA; Humans; Immunoglobulins; Indomethacin; Levamisole; Male; Middle Aged; Rosette Formation; Time Factors