PF4 and thrombophilia: Second, it suggests that patients with a positive PF4 test should be closely monitored for the development of AKI, perhaps with implementation of preventative strategies, such as the Kidney Disease Improving Global Outcomes bundle,26 or with more personalized strategies for kidney protection.27 Third, our findings suggest that hypercoagulability and the formation of platelet-rich microthrombi in the kidneys could be an important therapeutic target for AKI prevention in certain clinical settings associated with a hypercoagulable state.