The anticoagulant rodenticides brodifacoum and bromadiolone can cause acute kidney injury (AKI), although this is rare and poisoning usually manifests as bleeding. In the described case of a 37-year-old man, after mixed poisoning with these substances, anuria and macroscopic hematuria developed, while laboratory tests showed significant blood coagulation disorders (PT > 120 s, INR 13.58) and an increase in serum creatinine to 5.93 mg/dL. Imaging revealed bilateral ureteral dilatation with hydronephrosis and blood clots in the bladder. Toxicological analysis confirmed the presence of brodifacoum (24.7 ng/ml) and bromadiolone (12 ng/ml). Treatment included administration of vitamin K1, infusion of fresh frozen plasma, cystoscopic evacuation of blood clots, ureteroscopic placement of stents, and continuous renal replacement. After treatment, renal function improved significantly, serum creatinine decreased to 1.01 mg/dL, and coagulation parameters normalized. This case shows that AKI in anticoagulant poisoning can arise from a combination of anticoagulant nephropathy and urinary tract obstruction, and early and multidisciplinary treatment is key to reversing kidney damage.