rivaroxaban and Nephritis--Interstitial

BACKGROUND Direct oral anticoagulant agents (DOACs) have become increasingly more popular in recent years and have largely replaced warfarin in the treatment of certain conditions, such as atrial fibrillation, and in the prevention of thromboembolic events. Rivaroxaban is one of the most commonly used direct anticoagulant drugs for conditions such as atrial fibrillation and thromboprophylaxis. CASE REPORT We present a case of a 70-year-old male who developed acute interstitial nephritis after starting rivaroxaban, and who responded to medical treatment, which included corticosteroid therapy. A renal biopsy was not performed because the patient was on essential anticoagulation therapy secondary to a high CHADS2VASc score. CONCLUSIONS Dose adjustments when using rivaroxaban are necessary in patients with underlying renal failure. Acute interstitial nephritis is a rare condition associated with direct anticoagulant drugs. The treatment of acute interstitial nephritis is usually to remove the offending agent and treat the underlying cause.

Topics: Acute Disease; Aged; Atrial Fibrillation; Creatinine; Diagnosis, Differential; Factor Xa Inhibitors; Glucocorticoids; Humans; Male; Methylprednisolone; Nephritis, Interstitial; Renal Insufficiency, Chronic; Rivaroxaban

Topics: Aged, 80 and over; Atrial Fibrillation; Factor Xa Inhibitors; Heart Failure; Humans; Male; Nephritis, Interstitial; Rivaroxaban; Thrombophilia

Rivaroxaban is a direct oral anticoagulant that is prescribed for the prevention and treatment of thromboembolisms. Rivaroxaban is cleared renally and a common side effect (1-10%) is renal impairment of unknown pathophysiology. We are the first to describe a case of biopsy-proven acute tubulointerstitial nephritis, most likely caused by rivaroxaban.

Topics: Aged, 80 and over; Factor Xa Inhibitors; Humans; Male; Nephritis, Interstitial; Rivaroxaban