A Case Of Over Anti Coagulation And Acute Kidney Injury

Case A 56-year-old lady in her routine check-up and following observations were made. History She had long history of diabetes She had a problem of atrial fibrillation and had undergone mitral valve replacement some years ago.

She has been consuming warfarin for last 10 years and remained on anticoagulation after valve replacement. Her other medications include: Warfarin 3 mg OD Digoxin 250 mcg OD Bisoprolol 1.25 mg OD Fenofibrate 300 mg OD Furosemide 20 mg OD Potassium chloride 600 mg OD Glipizide 2.5 mg BiD Metformin 850 mg BiD Physical Examination No overt signs of bleeding Blood pressure 130/70 mmHg Heart rate 60 bpm Fundus photographs did not reveal diabetic retinopathy Laboratory Investigations Elevated Serum creatinine 317 μmol/L (6 months ago it was 72 μmol/L) In next 5 days, serum creatinine was raised to 428 μmol/L Urine microscopy: Microscopic hematuria International…