Abstract: Objective To investigate the clinical features, risk factors, mechanism, prevention and treatment strategies of warfarin related nephropathy (WRN) and the selection of anticoagulant drugs after WRN so as to provide reference for pharmaceutical care by clinical pharmacists.Methods One case of warfarin induced hematuria and AKI was reported. By searching such databases as PubMed, Medline, CNKI, Wanfang, and VIP, literature related to WRN was screened and analyzed.Results A total of 48 WRN cases were retrieved, in 87.50% of which INR was>3. The incidence of WRN was high 6-8 weeks after medication (29.17%). Patients aged 65 or older were more vulnerable (47.92%). The main clinical manifestations were increased levels of serum creatinine, microscopic/macroscopic hematuria and proteinuria. Forty-seven patients (97.92%) received renal puncture biopsy. Eighteen patients (37.50%) were complicated with basic nephropathy. Patients who did not use anticoagulant drugs a second time accounted for 8.33% (4/48) and relapsed warfarin treatment accounted for 27.27% (12/44). Renal function returned to normal in eleven patients (22.92%), incomplete renal function occurred in thirty-two patients (66.66%), and death in five patients (10.42%) within two years.Conclusion The incidence of WRN is not low and medical staff should be vigilant. Quick diagnosis and treatment of WRN and optimization of anticoagulant drug selection can contribute to patients' expected prognosis.

Key words: warfarin, acute renal injury, warfarin related nephropathy, case reports, literature analysis