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Direct oral anticoagulant and AKI: apixaban-induced acute interstitial nephritis
  1. Christina DiMaria1,
  2. Wael Hanna2,
  3. Julie Murone3 and
  4. James Reichart2
  1. 1 Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
  2. 2 Hospital Medicine, Lehigh Valley Hospital—Cedar Crest, Allentown, Pennsylvania, USA
  3. 3 Medicine, Philadelphia College of Medicine, Philadelphia, Pennsylvannia, USA
  1. Correspondence to Dr Christina DiMaria, dimariac{at}


Direct oral anticoagulants (DOACs)—dabigatran, rivaroxaban, apixaban and edoxaban—are changing the landscape of clinical practice for patients requiring short and long-term anticoagulation. We report a patient with no history of kidney disease developing acute interstitial nephritis (AIN) after starting a DOAC, apixaban. To date, this is the first biopsy proven case of apixaban-induced AIN.

  • acute renal failure
  • haematology (drugs and medicines)
  • renal system
  • haematology (incl blood transfusion)

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  • Contributors CD: conceived the need to write this case, completed the literature review and drafted the report. WH and JM: completed the critical revision of the report. Final approval of the version to be published was given by JR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.