Abstract
Background
Hypertension is a common comorbidity in patients with chronic kidney disease (CKD). We reported earlier that oral anticoagulants, including warfarin and dabigatran, may induce acute kidney injury. No effects of oral anticoagulants on blood pressure (BP) have been previously reported. The aim of this study was to examine in detail the relationship of anticoagulant therapy and BP in rats.Methods
Sham-operated and 5/6 nephrectomy rats were treated with different doses of oral anticoagulants (warfarin and dabigatran), superoxide scavenger N-acetylcysteine (NAC), vitamin K, and protease activated receptor 1 (PAR-1) inhibitor SCH79797. BP was measured by a tail cuff daily.Results
Warfarin and dabigatran both increased systolic BP in sham-operated and 5/6 nephrectomy rats in a dose-dependent manner. SCH79797 also increased systolic BP in a dose-dependent manner. Vitamin K prevented warfarin-induced increase in BP but did not affect BP when administered alone. NAC delayed the warfarin-associated increase in BP. Warfarin effects on BP were similar in 5/6 nephrectomy rats with different CKD stages.Conclusions
Both warfarin and dabigatran increase systolic BP in rats. The mechanism of this effect is not clear, but our data suggest that it is related to decreased thrombin activity associated with anticoagulant treatment. The superoxide scavenger NAC delayed, but did not prevent, warfarin-induced hypertension.Full text links
Read article at publisher's site: https://doi.org/10.1093/ajh/hpu129
Read article for free, from open access legal sources, via Unpaywall: https://academic.oup.com/ajh/article-pdf/28/2/182/8664452/hpu129.pdf
References
Articles referenced by this article (30)
Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate.
Kidney Int, (2):181-189 2011
MED: 21389969
Acute kidney injury during warfarin therapy associated with obstructive tubular red blood cell casts: a report of 9 cases.
Am J Kidney Dis, (6):1121-1126 2009
MED: 19577348
Warfarin therapy that results in an International Normalization Ratio above the therapeutic range is associated with accelerated progression of chronic kidney disease.
Nephron Clin Pract, (2):c142-6 2010
MED: 20413993
5/6 nephrectomy as a validated rat model mimicking human warfarin-related nephropathy.
Am J Nephrol, (4):356-364 2012
MED: 22473220
Warfarin-related nephropathy modeled by nephron reduction and excessive anticoagulation.
J Am Soc Nephrol, (10):1856-1862 2011
MED: 21885669
The unappreciated importance of blood pressure in recent and older atrial fibrillation trials.
J Hypertens, (11):2109-17; discussion 2117 2013
MED: 24077242
N-acetylcysteine ameliorates acute kidney injury but not glomerular hemorrhage in an animal model of warfarin-related nephropathy.
Am J Physiol Renal Physiol, (12):F1421-7 2013
MED: 23576637
A multicentre randomised clinical endpoint study of PARMA 5 computer-assisted oral anticoagulant dosage.
Br J Haematol, (2):274-283 2008
MED: 18759767
Effects of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure in rats.
J Huazhong Univ Sci Technolog Med Sci, (5):535-538 2008
MED: 18846333
Warfarin therapy and systolic hypertension in men with atrial fibrillation.
Am J Hypertens, (12 Pt 1):1592-1599 2005
MED: 16364831
Show 10 more references (10 of 30)
Citations & impact
Impact metrics
Citations of article over time
Alternative metrics
Article citations
N-acetylcysteine in Kidney Disease: Molecular Mechanisms, Pharmacokinetics, and Clinical Effectiveness.
Kidney Int Rep, 9(10):2883-2903, 20 Jul 2024
Cited by: 0 articles | PMID: 39430194 | PMCID: PMC11489428
Review Free full text in Europe PMC
Role of mitochondria in reno-cardiac diseases: A study of bioenergetics, biogenesis, and GSH signaling in disease transition.
Redox Biol, 76:103340, 05 Sep 2024
Cited by: 0 articles | PMID: 39250857 | PMCID: PMC11407069
Review Free full text in Europe PMC
Comparative Cardioprotective Effectiveness: NOACs vs. Nattokinase-Bridging Basic Research to Clinical Findings.
Biomolecules, 14(8):956, 07 Aug 2024
Cited by: 0 articles | PMID: 39199344 | PMCID: PMC11352257
Review Free full text in Europe PMC
Role of plasminogen activated inhibitor-1 in the pathogenesis of anticoagulant related nephropathy.
Front Nephrol, 4:1406655, 28 Jun 2024
Cited by: 0 articles | PMID: 39006160
N-acetylcysteine ameliorates hematuria-associated tubulointerstitial injury in 5/6 nephrectomy mice.
Physiol Rep, 11(13):e15767, 01 Jul 2023
Cited by: 4 articles | PMID: 37419616 | PMCID: PMC10328746
Go to all (14) article citations
Data
Similar Articles
To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
Warfarin-related nephropathy is the tip of the iceberg: direct thrombin inhibitor dabigatran induces glomerular hemorrhage with acute kidney injury in rats.
Nephrol Dial Transplant, 29(12):2228-2234, 05 Sep 2013
Cited by: 62 articles | PMID: 24009280
Efficacy and safety of dabigatran compared with warfarin in relation to baseline renal function in patients with atrial fibrillation: a RE-LY (Randomized Evaluation of Long-term Anticoagulation Therapy) trial analysis.
Circulation, 129(9):961-970, 09 Dec 2013
Cited by: 200 articles | PMID: 24323795
[Dabigatran, a new oral anticoagulant].
Brain Nerve, 63(4):411-415, 01 Apr 2011
Cited by: 0 articles | PMID: 21441645
Review
Implications of Dabigatran, a direct thrombin inhibitor, for oral surgery practice.
J Can Dent Assoc, 79:d74, 01 Jan 2013
Cited by: 17 articles | PMID: 23920075
Review