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CASE REPORT
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Page kidney complicating kidney biopsy after stopping Apixaban: A physician's dilemma


 Division of Nephrology, Department of Medicine, The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA

Correspondence Address:
Macaulay A. C. Onuigbo,
Division of Nephrology, Department of Medicine, The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT. UHC Campus, 1 South Prospect Street, Burlington, VT - 05401
USA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_269_19

Page kidney was described by Page, following very elaborate experiments with animal kidneys in 1939, with persistent arterial hypertension from “cellophane perinephritis.” Subsequently, it was reported after trauma, from renal cysts and tumors, and from intrarenal hematoma complicating percutaneous kidney biopsy. We describe Page kidney associated with acute kidney injury 26 days after an uncomplicated ultrasound-guided right native kidney biopsy. Patient was on Apixaban, a non-vitamin K antagonist oral anticoagulant (NOAC) for atrial fibrillation which was withheld 3 days before the procedure. It was restarted 3 days after. The evidence-base supporting guidelines and recommendations for the peri-procedural management of the NOACs is inadequate, sparse, and often conflicted. More research is warranted.


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Indian Journal of Nephrology
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