Literature case analysis of 32 patients with acute kidney injury induced by novel oral anticoagulants
OBJECTIVE To discuss the occurrence and clinical characteristics of acute kidney injury(AKI)induced by novel oral anticoagulants(NOACs)in order to provide reference for safe clinical drug use.METHODS The case reports of AKI induced by NOACs were retrieved from PubMed,Embase,CNKI,Wanfang and VIP database from inception to March 2023.The relevant data were collected and analyzed.RESULTS A total of 32 cases from 29 articles were identified and included in the analysis,including 16 males(50％)and 16 females(50％).The patients were aged from 59 to 86 years with an average age of(74.0±7.2)years old,and there were 31 patients aged 60 and above(96.9％).Totally 21(65.6％)cases were treated with dabigatran etexilate,7 cases(21.9％)with rivaroxaban,3 cases(9.4％)with apixaban,and 1 case(3.1％)with edoxaban(22.7％).The median time found for AKI was 51 days,and that of 19 cases(59.4％)was within 3 months.All the patients were with glomerular filtration rates less than 30 mL·min-1·(1.73 m2)-1.Meanwhile,27 cases(84.4％)had grade 3 AKI and 24 cases(75.0％)suffered varying degrees of hematuria.After drug withdrawal,corticosteroids treatment and hemodialysis,26 cases(81.2％)had good outcomes.CONCLUSION Different NOACs can cause AKI,and AKI is more common caused by dabigatran etexilate.A possible association with AKI should be considered while hematuria appears.For elderly patients with mul-tiple underlying diseases treated with drugs with risk of kidney injury,the detection of renal function should be strengthened,espe-cially during the first 3 months.Once AKI happens,NOACs must be stopped in time and targeted treatment should be carried out according to the pathological type.
novel oral anticoagulantacute kidney injuryanticoagulant-related nephropathyliterature case analysis
NETL
NSTL
万方数据
维普
