並列摘要
A 48-year-old male presented with gross hematuria and acute kidney injury (AKI) seven months after mitral and aortic valve replacements. Imaging studies showed no obstruction of the urinary tract, and laboratory tests revealed no significant findings except a mildly prolonged prothrombin time. AKI developed shortly after warfarin was titrated up, and dramatically improved after the discontinuation of warfarin, followed by forced diuresis. The Tc^(99)m-diethylenetriamine pentaacetic acid (DTPA) renogram showed near normal glomerular filtration rate with a markedly prolonged excretory time. Warfarin-related nephropathy (WRN) was the most likely diagnosis. We proposed that Tc^(99)m-DTPA renogram can be used to evaluate microscopic obstruction in the kidneys if WRN is suspected.
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