华法林抗凝、肉眼血尿、血清肌酐进行性升高  

Warfarin anticoagulation,gross haematuria and progressive renal dysfunction

作　　者：涂远茂[1] 周云[1] 谢红浪[1] 刘志红[1] 

机构地区：[1]南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所,南京210016

出　　处：《肾脏病与透析肾移植杂志》2016年第5期494-498,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：老年女性患者,生物瓣膜置换术后长期使用华法林抗凝。肾脏疾病病程4月,表现为持续镜下血尿、发作性肉眼血尿,血清肌酐进行性升高,查MPO-ANCA阳性,肾活检符合ANCA相关性肾炎合并Ig A肾病。患者发作肉眼血尿期间存在抗凝过度,停用抗凝剂后尿色转清、肾功能明显改善,考虑同时合并华法林相关肾病。A 66 year old woman underwent long-term anticoagulation therapy with warfarin due to bioprosthetic heart valve replacement. The renal involvement was noticed 4 months ago, manifesting persistent microscopic hematuria and paroxysmal gross hematuria with simultaneously serum creatinine increasing, in the case of excessive anticoagulation. Blood examination found positive MPO-ANCA and renal biopsy conformed the renal damage of ANCA associated vasculitis, combined with IgA nephropathy. Gross hematuria dissovled after anticoagulant withdrawal and renal function recovered spontaneously. So warfarin associated nephropathy was also considered..

关 键 词：华法林 急性肾损伤 华法林相关肾病 ANCA相关性血管炎 

分 类 号：R692[医药卫生—泌尿科学]