Apixaban/enoxaparin-sodium: Acute kidney injury in the form of nephropathy and leukocytoclastic vasculitis.

An 81-year-old man experienced acute kidney injury and leukocytoclastic vasculitis while being treated with apixaban and enoxaparin-sodium for atrial fibrillation. The man had a history of chronic kidney disease, atrial fibrillation, and chronic obstructive pulmonary disease. After starting apixaban, his renal function worsened, but improved when enoxaparin-sodium was initiated. However, after re-initiating apixaban, the man developed pulmonary consolidations, oedema, and haematuria. He was treated with methylprednisolone, underwent haemodialysis, and had a kidney biopsy that confirmed anticoagulant-related nephropathy. The man ultimately died from acute kidney injury, leukocytoclastic vasculitis, and multiple organ failure. The vasculitis and kidney injury were considered to be caused by apixaban and enoxaparin-sodium. [Extracted from the article]