Clinical characteristics of patients with segmental renal infarction

Abstract

SUMMARY:Background: Renal infarction is usually an underestimated disease due to its rare and non-specific presentations; the renal survival of these patients is not well studied. The aim of the present analysis is to study the clinical features and outcome in patients who had documented renal infarction. Methods: Twenty-two patients (12 men and 10 women, mean age of 57.7 ± 3.44 years (28.4-83.3 years)) with image-confirmed segmental renal infarction in the past 15 years were enrolled. All patients were followed up at outpatient department with a median of 4 years (1-14 years). Initial and follow-up clinical characteristics and laboratory results were recorded. Results: The most common underlying disease was cardiovascular disease. Renal infarction often presented with non-specific symptoms, including flank pain (55%), vague abdominal pain (50%), nausea/vomiting (46%) and fever (27%). The levels of leucocytes, lactate dehydrogenase, blood urea nitrogen and serum creatinine were all elevated at admission. The early diagnosis group (12/22) had more obvious flank pain, nausea/vomiting (P < 0.001) and higher alanine transaminase (P = 0.02). It also predisposed to undergo antiplatelet or anticoagulant therapy (all P < 0.04). During follow up, there was no recurrence in the whole study group, and a trend of better recovery of renal function was noted in the early diagnosis group. Conclusion: The serum creatinine level correlates with longer hospitalization length (P < 0.05). As regards long-term prognosis, no definite factor or treatment was found to have significant effect in segmental renal infarction patients. However, early diagnosis and early initiation of treatment seems to have a positive effect on future renal outcome.

Renal Infarction with two Different Etiologies: Two Case Reports

“…While some authors prefer surgical operation, others prefer conservative approaches such as anticoagulant or thrombolytic drugs. Surgical treatments are generally preferred in renal infarction cases of traumatic origin, especially in the renal infarction cases with complications such as renal artery dissection or active bleeding (2,3). If renal function and vital signs are normal in renal artery dissection, invasive treatment may not be necessary because medical treatment alone with strict blood pressure control is as effective as surgical management (8).…”

Renal Artery Embolism Diagnoed by Abdominal Ct and Successfully Managed Conservatively After Thirty-Six Hours: A Case Report.

“…Renal artery embolism (RAE) is an event that is rarely reported in the literature and is easily misdiagnosed due to its nonspecific presentations [1] RAE typically associated with atrial fibrillation (AF) [2,3] , however other coexisting conditions have been associated with RAE including aneurysmal disease, valvular or ischemic heart disease and advanced malignancy, previous infarction and pulmonary embolism [2,4].…”

Bilateral Renal Infarction in a Patient with Lung Carcinoma Treated with Cisplatin and Gemcitabine

“…An elevated serum lactate-dehydrogenase with little or no rise in serum aminotransferases is strongly suggestive of renal infarction, as seen in the present case. [6,7] Proteinuria and leucocytosis may also be seen. The classic radiological finding of renal infarction is a wedge-shaped perfusion defect without any mass effect in the adjacent parenchyma and without contour bulging.…”

“…[7][8][9] Acute renal infarction may manifest clinically as a pain similar to renal colic, and is often misdiagnosed as an acute pyelonephritis or renal colic because of similar presenting symptoms, as shown in the present case. [6,12] Also, in this case, we suspected tumor metastases of bilateral kidneys. An elevated serum lactate-dehydrogenase with little or no rise in serum aminotransferases is strongly suggestive of renal infarction, as seen in the present case.…”

“…[6][7][8][9][10] In the present case, we performed some laboratory analysis to elicit the etiology of the renal infarcts. We excluded the classical causes of renal infarction by laboratory analysis and medical history of the patient.…”