Journal Basic Info
- Impact Factor: 0.285**
- H-Index: 6
- ISSN: 2638-4558
- DOI: 10.25107/2638-4558
Major Scope
- Toxicology
- Pulmonary Disease
- Surgical
- Renal Disease
- Preventive Medicine
- Cancer Clinic
- Women’s Health Care
- Hypertension
Abstract
Citation: Clin Case Rep Int. 2021;5(1):1206.DOI: 10.25107/2638-4558.1206
Case Report: Possible Rivaroxaban Failure in Patient with Nephrotic Syndrome Discussing Anticoagulation in Nephrotic Syndrome
David B Mullen, Baely M DiRenzo, Todd A Walroth, Daren M Beam and Jeffrey A Kline
Indiana University School of Medicine, Indianapolis, USA
*Correspondance to: David B Mullen
PDF Full Text Case Report | Open Access
Abstract:
Kidney disease may cause development of nephrotic syndrome, which is characterized by a variety of factors, including hypoalbuminemia. A well-known complication of nephrotic syndrome is increased risk of Venous Thromboembolism (VTE), caused by various physiologic changes. Multiple treatment options are available for the treatment of VTE, including heparin, warfarin, and non-warfarin oral anticoagulants such as rivaroxaban. In this case report, we describe a 25-yearold male who presented to the Emergency Department (ED) with a Pulmonary Embolism (PE). He was deemed low-risk and eligible for discharge from the ED with rivaroxaban. The treatment is believed to have failed after he developed another VTE in a renal vein five months later while taking rivaroxaban daily. He was admitted to the hospital for thrombolysis and was subsequently diagnosed with nephrotic syndrome and hypoalbuminemia. There is no available data on the use of rivaroxaban in patients with nephrotic syndrome. Despite the fact that hypoalbuminemia could result in higher serum concentration of free drug for highly protein-bound agents such as rivaroxaban, the additional VTE risk inherent to NS appears to have led to re-thrombosis in this patient. Based on the pathophysiology of nephrotic syndrome, we caution the use of rivaroxaban in patients with this condition.
Keywords:
Rivaroxaban; Venous thromboembolism; Nephrotic syndrome; Hypoalbuminemia; Pulmonary embolism; Anticoagulation
Cite the Article:
Mullen DB, DiRenzo BM, Walroth TA, Beam DM, Kline JA. Case Report: Possible Rivaroxaban Failure in Patient with Nephrotic Syndrome Discussing Anticoagulation in Nephrotic Syndrome. Clin Case Rep Int. 2021; 5: 1206. .