Renal infarct volume and renal function decline in acute and chronic phases

Kagaya, Saeko; Yoshie, Osamu; Fukami, Hirotaka; Sato, Hiroyuki; Saito, Ayako; Takeuchi, Yoichi; Matsuda, Ken; Nagasawa, Tasuku

doi:10.1007/s10157-017-1399-4

Cited by 14 publications

(14 citation statements)

References 18 publications

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“…Similarly, another study observed that although acute kidney injury was present in 40.7% of the study patients, long-term renal outcome was relatively good [10]. The volume of the infarction has been suggested to be a factor in the degree of renal function decline in acute renal infarction [11].…”

Section: Discussionmentioning

confidence: 96%

Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction

2018

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Patient: Male, 47Final Diagnosis: Acute renal and splenic infarctionSymptoms: Flank pain • low-grade feverMedication: —Clinical Procedure: CT scanSpecialty: NephrologyObjective:Challenging differential diagnosisBackground:This is a case report of a male patient who presented with a history of right flank pain based on renal infarction. Initially the symptoms were misdiagnosed as acute pyelonephritis.Case Report:A 47-year-old male with a history of familial hypercholesterolemia and cerebral infarction presented at the Emergency Department with a 3-day history of acute right-sided flank pain. Physical examination revealed hypertension, subfebrile temperature, and costovertebral angle tenderness. Blood tests were unremarkable except for renal impairment, a high C-reactive protein level of 215 mg/L (normal <8 mg/dL) and an elevated lactate dehydrogenase (LDH) of 1289 U/L (normal <248 U/L). Renal ultrasonography was normal. He was admitted with a presumed diagnosis of acute pyelonephritis and treated accordingly. However, 2 days later, we rejected this diagnosis as the urine culture was sterile. Based on the acute onset of symptoms and the initial high LDH, renal infarction was suspected. A computed tomography scan confirmed right-sided partial renal and splenic infarctions likely due to spreading emboli from atherosclerosis of the descending aorta.Conclusions:Acute renal infarction is often missed or delayed as a diagnosis because patients often present with flank pain that can resemble more frequently encountered conditions such as pyelonephritis and nephrolithiasis. Renal infarction should be considered in cases with acute flank pain accompanied by (low-grade) fever, high LDH level, increased C-reactive protein level, hypertension, and renal impairment, especially in those patients with an increased risk of thromboembolism.

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Section: Discussionmentioning

confidence: 96%

Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction

2018

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“…Renal dysfunction with high morbidity can also be seen after RI. Renal dysfunction is associated with the size of the infarction area [12,13]. Patients with renal dysfunction before RI, bilateral cases and unilateral global infarctions often present with impaired renal functions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Approach to Renal Artery Thromboembolism

Kartal

Alkış

Çetinkaya

et al. 2020

Archives of Clinical and Experimental Medicine

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Aim: We aimed to reveal the clinical, laboratory, radiological findings of infarction in the renal artery and its branches due to thrombosis, its effects on renal functions and the measures to be taken. Methods: The study sample included 8 patients who were admitted to the emergency department of Kutahya University of Health Sciences Evliya Celebi Training and Research Hospital between 2018-2020, and who were hospitalized with the diagnosis of acute renal infarction. Patients were retrospectively analyzed with clinical findings, CT angiography-abdomen, clinical observations, prognosis and complications. Results: Of the patients, 5 were male and 3 were female. The mean age was 55.13 (29-69) years. One patient presented with bilateral renal infarction, while 7 had unilateral renal infarction. The etiology of the patients was idiopathic in 2, atrial fibrilation (AF) in 3 patients, and atherosclerosis in 3 patient. The mean serum creatinine of 1.24 (0.7-3.2) mg/dl and the mean blood leukocyte level of 16925 (11000-26000) mcL were determined. The mean length of hospital stay was 4.6 (3-7) days. Anticoagulant therapy was initiated in all patients for risk of recurrent renal infarction and thromboembolism. Conclusion: We revealed that renal infarction, rarely seen in urology practice, has nonspecific clinical findings; therefore, it should be kept in mind in differential diagnosis for patients presenting with sudden-onset oblique or abdominal pain, and that diagnosis can be made using contrast-enhanced CT. We determined that AF and valvular heart diseases which cause atherosclerosis and cardiac thrombosis play an important role in the etiology.

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“…Se ha asociado al pico del valor de la LDH con el volumen del infarto y con la disminución del filtrado glomerular en la fase aguda del infarto pero no en la fase crónica (46) . Esto haría a la LDH como la opción más apropiada dentro de los marcadores serológicos para despistar el diagnostico en vista a solicitar una tomografía con contraste o si se tuviera una tomografía no concluyente como un elemento para orientar el diagnostico.…”

Section: Discussionunclassified

“…Previamente se ha reportado que el desarrollo de injuria renal tanto aguda como progresión a la enfermedad renal crónica se asocia a mayor edad, diabetes mellitus (32) , y mayor volumen del infarto (46) . Y se ha relacionado la ocurrencia de injuria renal con el grado de proteinuria y la presencia de hematuria microscópica, niveles más altos de AST, ALT, LDH (4) y PCR (32) .…”

Section: Discussionunclassified

Infarto renal: revisión sistemática sobre síntomas de sospecha clínica y repercusión sobre función renal

Pizzarossa

Rodríguez

2019

Rev. urug. med. interna

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Renal infarction: systematic review of symptoms of clinical suspicion and repercussion on renal function Infarto renal: revisão sistemática dos sintomas de suspeita clínica e repercussão na função renal Resumen: El infarto renal es una entidad poco frecuente y está sub-diagnosticada por lo que para su diagnóstico se necesita un alto índice de sospecha clínica. Objetivo: Determinar las características clínicas y paraclínicas más frecuentes en el infarto renal, destacando la repercusión en la función renal. Metodología: Se realizó una revisión sistemática de serie de casos en PUBMED y SciELO con los términos: "renal infarction" y "renal infarct". Se estudiaron variables: demográficas, clínicas y paraclínicas. En el caso de las variables paraclínicas se analizó el porcentaje de pacientes con valores elevados de cada una de las mismas. El análisis estadístico fue realizado con EPI INFO 7. 2. Resultados: Los síntomas y signos más frecuentes fueron oliguria, dolor en flanco y abdominal, nauseas, fiebre y vómitos. Los parámetros paraclínicos alterados fueron: LDH, PCR y glóbulos blancos. Se constató injuria renal aguda en 30.8% de los pacientes, la progresión a enfermedad renal crónica se observó en 17.3% y la progresión a enfermedad renal terminal se observó en 5.2% de los pacientes. Discusión y conclusiones: La determinación de las características clínicas y paraclínicas más frecuentes del infarto renal, se pueden utilizar para disminuir el retraso diagnóstico, lo que tiene consecuencias terapéuticas.

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Renal infarct volume and renal function decline in acute and chronic phases

Abstract: The volume of the infarction may be a factor in the degree of renal function decline in ARI. Therefore, assessment of infarct volume in ARI is important.

Cited by 14 publications

References 18 publications

Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction

Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction

Clinical Approach to Renal Artery Thromboembolism

Infarto renal: revisión sistemática sobre síntomas de sospecha clínica y repercusión sobre función renal

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