{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:12:06Z","timestamp":1748059926449},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006390","name":"University of Lausanne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006390","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Dabigatran is an oral anticoagulant that is mainly renally excreted. Despite its efficacy in preventing thromboembolic events, concerns arise regarding bleeding complications in patients with acute kidney injury. Idarucizumab is its specific antidote and reverses quickly and effectively dabigatran anticoagulation effects in situations of severe bleeding or pending surgical procedures, but its benefit beyond these two indications remains uncertain. We present a case of a woman with atrial fibrillation anticoagulated by dabigatran and admitted with <jats:italic>Streptococcus agalactiae<\/jats:italic> meningitis, acute kidney injury and dabigatran accumulation. Idarucizumab was not administered initially as she did not meet its current strict indications. However, subsequently, significant bleeding necessitated its use. A rebound increase in dabigatran concentration was associated with an intracranial hemorrhage, but the combination of additional doses of idarucizumab with hemodialysis lowered the dabigatran concentration and prevented significant rebound increases. Further investigation into the optimal management of dabigatran accumulation and acute kidney injury-associated bleeding is needed to enhance patient outcomes and safety. Early initiation of hemodialysis together with idarucizumab administration may be crucial in preventing life-threatening bleeding events in these patients.<\/jats:p>","DOI":"10.1186\/s12245-024-00677-3","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T09:02:12Z","timestamp":1721206932000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dabigatran accumulation in acute kidney injury: is more better than less to prevent bleeding? A case report"],"prefix":"10.1186","volume":"17","author":[{"given":"Rafik","family":"Matbouli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Pantet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Castioni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nima","family":"Vakilzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Alberio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Hugli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"677_CR1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1136\/heartjnl-2022-321377","volume":"109","author":"M Joy","year":"2023","unstructured":"Joy M, Williams J, Emanuel S, et al. Trends in direct oral anticoagulant (DOAC) prescribing in English primary care (2014\u20132019). Heart. 2023;109:195\u2013201.","journal-title":"Heart"},{"key":"677_CR2","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.thromres.2023.03.010","volume":"225","author":"AI Geller","year":"2023","unstructured":"Geller AI, Shehab N, Lovegrove MC, et al. Bleeding related to oral anticoagulants: Trends in US emergency department visits, 2016\u20132020. Thromb Res. 2023;225:110\u20135.","journal-title":"Thromb Res"},{"key":"677_CR3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2165\/11318170-000000000-00000","volume":"49","author":"J Stangier","year":"2010","unstructured":"Stangier J, Rathgen K, Stahle H, et al. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. 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