Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 15 4 2026 10 01 Case report: rivaroxaban related nephropathy e17343 e17343 10.34172/jnp.2022.17343 EN Luisa Lemos Costa https://orcid.org/0000-0002-9155-0336 Ana Rodrigues https://orcid.org/0000-0002-9203-478X Raquel Pinto https://orcid.org/0000-0001-5907-3675 Carla Lima https://orcid.org/0000-0002-5085-4552 Tânia Sousa https://orcid.org/0000-0001-7587-1212 Helena Viana https://orcid.org/0000-0002-7644-2230 Mário Góis https://orcid.org/0000-0002-0937-8611 Sérgio Lemos https://orcid.org/0000-0001-7480-0885 Andreia Silva https://orcid.org/0000-0002-5417-2188 Journal Article 10.34172/jnp.2022.17343 2022 01 05 2022 01 28 The characteristics of direct oral anticoagulants (DOACs) make them more appealing for prevention of thromboembolic events than vitamin K antagonists (VKA). Despite that, both classes have been a recognized as a cause of anticoagulant related nephropathy (ARN). Herein we describe a case of a 72-year-old man, with chronic kidney disease (CKD), medicated with rivaroxaban, who presented with acute kidney injury (AKI) and microscopic hematuria. The kidney biopsy revealed anticoagulant related-nephropathy. Rivaroxaban was suspended, the patient showed improvement of renal function and apixaban was prescribed. This case emphasizes the need for careful monitoring of serum creatinine when these drugs are prescribed, especially in high risk groups.