Acute Renal Infarction

Abstract

SummaryBackground and objectives Renal infarction is an arterial vascular event that may cause irreversible damage to kidney tissues. This study describes the clinical characteristics of patients with renal infarction according to underlying mechanism of vascular injury.Design, setting, participants, & measurements This study retrospectively identified 94 patients with renal infarction diagnosed between 1989 and 2011 with the aim of highlighting potential correlations between demographic, clinical, and biologic characteristics and the etiology of renal infarction. Four groups were identified: renal infarction of cardiac origin (cardiac group, n=23), renal infarction associated with renal artery injury (renal injury group, n=29), renal infarction associated with hypercoagulability disorders (hypercoagulable group, n=15), and apparently idiopathic renal infarction (idiopathic group, n=27).Results Clinical symptoms included abdominal and/or flank pain in 96.8% of cases; 46 patients had uncontrolled hypertension at diagnosis. Laboratory findings included increase of lactate dehydrogenase level (90.5%), increase in C-reactive protein level (77.6%), and renal impairment (40.4%). Compared with renal injury group patients, this study found that cardiac group patients were older (relative risk for 1 year increase=1.21, P=0.001) and displayed a lower diastolic BP (relative risk per 1 mmHg=0.94, P=0.05). Patients in the hypercoagulable group had a significantly lower diastolic BP (relative risk=0.86, P=0.005). Patients in the idiopathic group were older (relative risk=1.13, P=0.01) and less frequently men (relative risk=0.11, P=0.02). Seven patients required hemodialysis at the first evaluation, and zero patients died during the first 30 days.Conclusions This study suggests that the clinical and biologic characteristics of patients can provide valuable information about the causal mechanism involved in renal infarction occurrence.

Acute renal infarction: a single center experience

“…Major risk factors for renal infarction include atrial fibrillation, valvular or ischemic heart disease, renal artery thrombosis/dissection and coagulopathy. Etiology remains unknown in many cases [4,6,7]. We describe the clinical and radiological characteristics and renal prognosis of 18 patients with acute renal infarction.…”

“…Non-specific clinical presentation mimicking other pathologic states (e.g. urolithiasis, acute pyelonephritis, other acute abdominal diseases) often causes a delay in the diagnosis, which may increase the risk of impaired renal failure [3][4][5]. Radiologic diagnosis of renal infarction is based on enhanced contrast computed tomography (CT), which typically indicates the presence of a wedge-shaped hypodense area in the peripheral region [2].…”

Two renal infarction cases with different etiologies

“…[1] Genellikle hastalar akut balangıçlı yan veya karın a¤rısı ve nadir olarak bulantı, kusma, ate gibi belirtiler ile bavurmaktadır. [1][2][3][4] ‹skemi sonrasında renin artıı nedeniyle kan basıncında yükseklik olabilir. Genellikle lökositoz, CRP, LDH, bazen aspartat transaminaz (AST), ALT düzey-lerinde yükseklik ile ortaya çıkar.…”

“…‹dyopatik olan olgular ile birlikte bazı olgularda altta yatan etyolojik neden saptanabilmektedir. Tromboemboli; ana renal arter veya segmental arterin tamamen tıkan-masına neden olabilen özellikle kalp veya aorttan köken alan bir trombüs, altta yatan hiperkoagüla-bilite durumları, renal arter hasarı [1][2][3] ve nadir olarak fibromusküler displazi (FMD) bu nedenler arasındadır. Etyolojide, renal arter hasarı ile birlikte renal enfarktüs grubunda renal arter diseksiyonu, FMD ve renal arterin trombotik anevrizmaları ile birlikte Ehlers-Danlos sendromu yer almaktadır.…”

A Case Report of Renal Artery Thrombosis in a Patient with Occult Neuroendocrine Tumor

“…In the largest study evaluating causes of renal artery thrombosis by Bourgault, et al [4], 94 patients were evaluated for etiology of renal infarction. The most common etiologies were renal infarction of cardiac origin and renal infarction associated with renal artery injury.…”