2) Our guest author is Isha Tiwari MD DM @nephronisha
— @CKD_ce (@ckd_ce) January 9, 2024
Our topic for 🆓 CE/#CME : #ARN – Anticoagulant Related Nephropathy#MedTwitter #nephtwitter @ISNkidneycare pic.twitter.com/zqDybWxBd4
4) FOLLOW US at @ckd_ce and at @KIReports for more expert #MedEd in #kidneydisease. #FOAMed @MedTweetorials #CardioTwitter #cvCoag
— @CKD_ce (@ckd_ce) January 9, 2024
6) Let's have a poll on this!
— @CKD_ce (@ckd_ce) January 9, 2024
8) On one hand, warfarin is lifesaving for pts with DVT or PE … but it has been found to also have potential detrimental effects on kidneys!
— @CKD_ce (@ckd_ce) January 9, 2024
“Anticoagulant Related Nephropathy” (#ARN) is a type of #AKI that may be caused by excessive anticoagulation.https://t.co/pywpIJiXAJ
10) The answer is a gigantic figure of 50% 😯
— @CKD_ce (@ckd_ce) January 9, 2024
Outcomes of patients with #ARN were recently published in @KIReports by @alanadasguptahttps://t.co/DtIgzOenO7 pic.twitter.com/8fgXygyjaF
12) Pathogenesis of #ARN
— @CKD_ce (@ckd_ce) January 9, 2024
● Glomerular hemorrhage
● Obstruction of renal tubules by red blood cell (RBC) casts
● Tubular epithelial cell injury pic.twitter.com/vvgHte4t4G
14) This table shows the various histopathological features of all the patients of #ARN, as found in the study, including sclerosis, crescents, IFTA, casts and glomerular disease. 👇 pic.twitter.com/YRFs5yyLDL
— @CKD_ce (@ckd_ce) January 9, 2024
16) Presumptive diagnosis is made after ruling out other causes of AKI.
— @CKD_ce (@ckd_ce) January 9, 2024
🔬Kidney biopsy done if:
1) Serum creatinine 📈 remains high even after INR reaches baseline.
2) Hematuria 🩸 persists or emerges after restoration of a therapeutic INR.
18) ✅Prevention primarily involves proper adjustment of anticoagulant dose to therapeutic levels.
— @CKD_ce (@ckd_ce) January 9, 2024
⚠️Special attention needed in patients with underlying CKD, who are the most vulnerable for having #ARN. pic.twitter.com/WTBZNT9MaU
20a) How soon does #ARN typically occur in affected patients?
— @CKD_ce (@ckd_ce) January 9, 2024
a. Within 1wk of elevated INR
b. Within 2wk of starting warfarin
c. Within 1mo of starting dabigatran
d. Within 24h of starting heparin
20c) The best measure/s for prevention of #ANR in pts requiring #anticoagulation are
— @CKD_ce (@ckd_ce) January 9, 2024
a. Avoid overanticoagulation with warfarin
b. In pts with CKD, check kidney #biopsy before starting anticoag
c. Use warfarin instead of a #DOAC so #INR can be monitored
d. b&c
21) That’s it! Thank you for joining us, and huge thanks and shoutout to the authors of the @KIReports article ✍️: Alana Dasgupta, Galina Mikhalina, @anjalisatoskar, Laura Biederman, @BradRovin, @samirparikhmd, & Sergey V. Brodsky
— @CKD_ce (@ckd_ce) January 9, 2024
22) You just earned 0.5hr 🆓CE/CME! Claim your certificate now at https://t.co/SE8TGzLwv1 and share this #tweetorial with your followers and friends! Thanks to @nephronisha for authoring & @sophia_kidney for managing!#FOAMed #nephtwitter @ISNkidneycare @KIReports @goKDIGO
— @CKD_ce (@ckd_ce) January 9, 2024