Acenocoumarol as an alternative anticoagulant in a patient with warfarin-related nephropathy

Adverse EventWarfarin-related nephropathy. Drug ImplicatedWarfarin. The PatientA 31-year-old female, managed with warfarin for rheumatic heart disease with atrial fibrillation. Evidence that Links the Drug to the EventThere were no alternative causes of nephropathy that could have caused the adverse event in this patient. ManagementShifting the drug from warfarin to acenocoumarol. MechanismDifference in renal elimination between warfarin and acenocoumarol. Implication for TherapyClinicians should be aware of this rare adverse effect of warfarin, and acenocoumarol can be considered as an alternative therapy for this condition. Hypotheses to be TestedFurther prospectively designed studies are needed to consider acenocoumarol as an alternative therapy in warfarin-related nephropathy.