• Jenan Awesat, Iftach Sagy, Yosef S Haviv, Anat Rabinovich, Alan Jotkowitz, Elena Shleyfer, and Leonid Barski.
• Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel. Electronic address: ginanaw@clalit.org.il.
• Thromb. Res. 2018 Sep 1; 169: 120-122.

BackgroundAnticoagulant induced renal injury has been previously described with Warfarin treatment. In the last decade direct oral anticoagulants (DOAC) were introduced. They include direct inhibitors of factor Xa (Rivaroxaban, Apixaban, Edoxaban) and a thrombin inhibitor (Dabigatran). There are isolated reports describing acute kidney injury (AKI) due to the use of DOACs.Case ReportWe report a clinical case of an 80-year-old patient recently started on Dabigatran for new onset atrial fibrillation. She presented with AKI and hematuria, urine specimen showed RBC casts, and a working diagnosis of anticoagulant nephropathy due to Dabigatran was made. During hospitalization she was treated with Idarucizumab with a full recovery of renal function. To the best of our knowledge, there are 4 published case reports describing kidney injury produced by Dabigatran.ConclusionThe use of DOACs is increasing rapidly, with increasing concern about its safety profile and, in particular, its potential harmful effect on renal function. As described in our case, treatment with Praxbind for Dabigatran induced kidney injury may be an acceptable management strategy that may obviate the need for urgent dialysis in selected cases by complete reversal of the AKI.Copyright © 2018. Published by Elsevier Ltd.

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