華法林相關腎病_West China Medical Journal

Authors：

王偉 ,  陶冶

四川大學華西醫院腎臟內科（成都 610041）;

Corresponding?author：

陶冶, Email: tyehuaxi@163.com

Keywords：

華法林; 急性腎損傷; 華法林相關腎病

DOI：

10.7507/1002-0179.20150394

Video：

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Abstract Full text Figures/Tables Video References Cited by

華法林相關腎病（WRN）是一種最近被認知的疾病。2009年美國俄亥俄州立大學發現在接受華法林治療的患者，治療過程中可以引起急性腎損傷。他們考慮到這種急性腎損傷可能是華法林治療的一種以前未知的并發癥，即WRN。其具體發病機制目前仍未明確，未來針對其具體發病機制仍需要更多的研究。目前一般認為急性腎小管損傷、腎小球毛細血管袢斷裂，脫落紅細胞阻塞腎小管仍然是WRN 的主要發病機制。動物實驗表明維生素K 可以阻止WRN 進展，然而臨床上對其仍未有明確的治療方法。WRN患者的病死率高，故在華法林治療期間密切監測國際標準化比值及血肌酐值，以便早期診斷及及時治療。正確的認知WRN 的臨床特征，對降低患者病死率和及時的臨床干預有重要意義。

Citation： 王偉, 陶冶. 華法林相關腎病. West China Medical Journal, 2015, 30(7): 1365-1368. doi: 10.7507/1002-0179.20150394 Copy

1.	Brodsky SV, Satoskar A, Chen J, et al. Acute kidney injury during warfarin therapy associated with obstructive tubular red blood cell casts:a report of 9 cases[J]. Am J Kidney Dis, 2009, 54(6):1121-1126.
2.	Ware K, Brodsky P, Satoskar AA, et al. Warfarin-related nephropathy modeled by nephron reduction and excessive anticoagulation[J]. J Am Soc Nephrol, 2011, 22(10):1856-1862.
3.	Limdi NA, Beasley TM, Baird MF, et al. Kidney function influences warfarin responsiveness and hemorrhagic complications[J]. J Am Soc Nephrol, 2009, 20(4):912-921.
4.	Ansell J, Hirsh J, Hylek E, et al. Pharmacology and management of the vitamin K antagonists:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)[J]. Chest, 2008, 133(6 Suppl):160S-198S.
5.	Budnitz DS, Shehab N, Kegler SR, et al. Medication use leading to emergency department visits for adverse drug events in older adults[J]. Ann Intern Med, 2007, 147(11):755-765.
6.	Ryan M, Ware K, Qamri Z, et al. Warfarin-related nephropathy is the tip of the iceberg:direct thrombin inhibitor dabigatran induces glomerular hemorrhage with acute kidney injury in rats[J]. Nephrol Dial Transplant, 2014, 29(12):2228-2234.
7.	Cheungpasitporn W, Kaewpoowat Q, Prasidthrathsint K, et al. Warfarin-related nephropathy can be mimicked by an interaction between sulfonamide derivatives and vitamin K antagonists[J]. Kidney, 2011, 80(11):1246.
8.	An JN, Ahn SY, Yoon CH, et al. The occurrence of warfarin-related nephropathy and effects on renal and patient outcomes in korean patients[J]. PLos One, 2013, 8(4):e57661.
9.	Brodsky SV, Nadasdy T, Rovin BH, et al. Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate[J]. Kidney Int, 2011, 80(2):181-189.
10.	Tárnoky AL. Warfarin and albumin[J]. Br Med J (Clin Res Ed), 1982, 285(6344):812.
11.	Tsao SC, Sugiyama Y, Sawada Y, et al. Effect of albumin on hepatic uptake of warfarin in normal and an albuminemic mutant rats:analysis by multiple indicator dilution method[J]. J Pharmacokinet Biopharm, 1986, 14(1):51-64.
12.	Demirkan K, Stephens MA, Newman KP, et al. Response to warfarin and other oral anticoagulants:effects of disease states[J]. South Med J, 2000, 93(5):448-454.
13.	Chang CC, Liou HH, Wu CL, et al. Warfarin slows deterioration of renal function in elderly patients with chronic kidney disease and atrial fibrillation[J]. Clin Interv Aging, 2013(8):523-529.
14.	Limdi NA, Limdi MA, Cavallari L, et al. Warfarin dosing in patients with impaired kidney function[J]. Am J Kidney Dis, 2010, 56(5):823-831.
15.	Yanagita M, Ishii K, Ozaki H, et al. Mechanism of inhibitory effect of warfarin on mesangial cell proliferation[J]. J Am Soc Nephrol, 1999, 10(12):2503-2509.
16.	Yanagita M. Gas6, warfarin, and kidney diseases[J]. Clin Exp Nephrol, 2004, 8(4):304-309.
17.	Coughlin SR. Protease-activated receptors in hemostasis, thrombosis and vascular biology[J]. J Thromb Haemost, 2005, 3(8):1800-1814.
18.	Coughlin SR. Protease-activated receptors in vascular biology[J]. Thromb Haemost, 2001, 86(1):298-307.
19.	Rondeau E, Vigneau U, Berrou J. Role of thrombin receptors in the kidney:lessons from PAR1 knock-out mice[J]. Nephrol Dial Transplant, 2001, 16(8):1529-1531.
20.	Xu Y, Zacharias U, Peraldi MN, et al. Constitutive expression and modulation of the functional thrombin receptor in the human kidney[J]. Am J Pathol, 1995, 146(1):101-110.
21.	Yanagita M. Gas6, warfarin, and kidney diseases[J]. Clin Exp Nephrol, 2004, 8(4):304-309.
22.	Brodsky SV, Collins M, Park E, et al. Warfarin therapy that results in an International Normalization Ratio above the therapeutic range is associated with accelerated progression of chronic kidney disease[J]. Nephron Clin Pract, 2010, 115(2):c142-c146.
23.	Brodsky SV, Nadasdy T, Rovin BH, et al. Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate[J]. Kidney Int, 2011, 80(2):181-189.

1. Brodsky SV, Satoskar A, Chen J, et al. Acute kidney injury during warfarin therapy associated with obstructive tubular red blood cell casts:a report of 9 cases[J]. Am J Kidney Dis, 2009, 54(6):1121-1126.
2. Ware K, Brodsky P, Satoskar AA, et al. Warfarin-related nephropathy modeled by nephron reduction and excessive anticoagulation[J]. J Am Soc Nephrol, 2011, 22(10):1856-1862.
3. Limdi NA, Beasley TM, Baird MF, et al. Kidney function influences warfarin responsiveness and hemorrhagic complications[J]. J Am Soc Nephrol, 2009, 20(4):912-921.
4. Ansell J, Hirsh J, Hylek E, et al. Pharmacology and management of the vitamin K antagonists:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)[J]. Chest, 2008, 133(6 Suppl):160S-198S.
5. Budnitz DS, Shehab N, Kegler SR, et al. Medication use leading to emergency department visits for adverse drug events in older adults[J]. Ann Intern Med, 2007, 147(11):755-765.
6. Ryan M, Ware K, Qamri Z, et al. Warfarin-related nephropathy is the tip of the iceberg:direct thrombin inhibitor dabigatran induces glomerular hemorrhage with acute kidney injury in rats[J]. Nephrol Dial Transplant, 2014, 29(12):2228-2234.
7. Cheungpasitporn W, Kaewpoowat Q, Prasidthrathsint K, et al. Warfarin-related nephropathy can be mimicked by an interaction between sulfonamide derivatives and vitamin K antagonists[J]. Kidney, 2011, 80(11):1246.
8. An JN, Ahn SY, Yoon CH, et al. The occurrence of warfarin-related nephropathy and effects on renal and patient outcomes in korean patients[J]. PLos One, 2013, 8(4):e57661.
9. Brodsky SV, Nadasdy T, Rovin BH, et al. Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate[J]. Kidney Int, 2011, 80(2):181-189.
10. Tárnoky AL. Warfarin and albumin[J]. Br Med J (Clin Res Ed), 1982, 285(6344):812.
11. Tsao SC, Sugiyama Y, Sawada Y, et al. Effect of albumin on hepatic uptake of warfarin in normal and an albuminemic mutant rats:analysis by multiple indicator dilution method[J]. J Pharmacokinet Biopharm, 1986, 14(1):51-64.
12. Demirkan K, Stephens MA, Newman KP, et al. Response to warfarin and other oral anticoagulants:effects of disease states[J]. South Med J, 2000, 93(5):448-454.
13. Chang CC, Liou HH, Wu CL, et al. Warfarin slows deterioration of renal function in elderly patients with chronic kidney disease and atrial fibrillation[J]. Clin Interv Aging, 2013(8):523-529.
14. Limdi NA, Limdi MA, Cavallari L, et al. Warfarin dosing in patients with impaired kidney function[J]. Am J Kidney Dis, 2010, 56(5):823-831.
15. Yanagita M, Ishii K, Ozaki H, et al. Mechanism of inhibitory effect of warfarin on mesangial cell proliferation[J]. J Am Soc Nephrol, 1999, 10(12):2503-2509.
16. Yanagita M. Gas6, warfarin, and kidney diseases[J]. Clin Exp Nephrol, 2004, 8(4):304-309.
17. Coughlin SR. Protease-activated receptors in hemostasis, thrombosis and vascular biology[J]. J Thromb Haemost, 2005, 3(8):1800-1814.
18. Coughlin SR. Protease-activated receptors in vascular biology[J]. Thromb Haemost, 2001, 86(1):298-307.
19. Rondeau E, Vigneau U, Berrou J. Role of thrombin receptors in the kidney:lessons from PAR1 knock-out mice[J]. Nephrol Dial Transplant, 2001, 16(8):1529-1531.
20. Xu Y, Zacharias U, Peraldi MN, et al. Constitutive expression and modulation of the functional thrombin receptor in the human kidney[J]. Am J Pathol, 1995, 146(1):101-110.
21. Yanagita M. Gas6, warfarin, and kidney diseases[J]. Clin Exp Nephrol, 2004, 8(4):304-309.
22. Brodsky SV, Collins M, Park E, et al. Warfarin therapy that results in an International Normalization Ratio above the therapeutic range is associated with accelerated progression of chronic kidney disease[J]. Nephron Clin Pract, 2010, 115(2):c142-c146.
23. Brodsky SV, Nadasdy T, Rovin BH, et al. Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate[J]. Kidney Int, 2011, 80(2):181-189.

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