Saturday, September 22, 2018

Anticoagulant nephropathy: is it unique to warfarin?

Probably not but it is at least worse with warfarin. Here’s the latest comparative study. The reason? Although all anticoagulants have a common mechanism (intraglomerular and intratubular hemorrhage) warfarin has a second one. It promotes vascular calcification in the kidney. It does this by inhibiting the local carboxylation of certain vascular protective proteins. But there’s even more to it than that. NOACs, by their inhibition of factors II and X, may be vascular protective because these clotting factors are involved in vascular inflammation, according to the audio summary for the JACC article linked above.

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