American Journal of Hypertension 1 Original article

Warfarin is the most commonly prescribed oral anticoagulant in the world. For more than a half century, warfarin has been used in patients with increased risk for thromboembolisms, sav-ing many lives. However, like any other drug, warfarin has side effects, and some of them are dangerous. We recently described that, in a selected patient population, warfarin may result in acute kidney injury (AKI) and increased risk of death in the first few weeks after onset of the AKI, which is unexpected.1,2 We named this AKI warfarin-related nephropathy (WRN). Patients with chronic kidney disease (CKD) are at higher risk for devel-oping WRN.1,3 We modeled this condition in rats and demon-strated that the 5/6 nephrectomy model of CKD is an adequate experimental tool to study WRN.4,5 Recently, we demonstrated that not only warfarin, but also the novel direct thrombin inhib-itor dabigatran, results in WRN-like injury in the kidney with occlusive red blood cell cast formation.6 Based on our clinical studies, hypertension is a risk fac-tor for developing WRN.1,3 However, no data are avail-able regarding whether warfarin or dabigatran affect blood pressure (BP) in experimental animals or humans. Numerous clinical trials did not provide clear information about BP changes in patients on oral anticoagulation.7 The aim of this study was to analyze changes in systemic BP in rats treated with oral anticoagulants