Idiopathic Renal Infarction and Anticoagulation

Khayat, Maurice; Nee, Robert; Little, Dustin J.; Olson, Stephen W.

doi:10.1055/s-0039-1698757

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…The SARS-CoV2 (COVID-19) infection was also seen to cause renal infarcts possibly through mechanisms such as an increase in pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-a) and interleukin (IL)1, IL2, and IL6 [ 6 ]. Idiopathic renal infarcts should be considered in patients after other etiologies are ruled out such as risk factors for thromboembolism, disorders causing hypercoagulability, and renal vascular pathology [ 7 ]. Due to the rare incidence of idiopathic infarcts, the pathophysiology has not been well studied [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Idiopathic renal infarcts should be considered in patients after other etiologies are ruled out such as risk factors for thromboembolism, disorders causing hypercoagulability, and renal vascular pathology [ 7 ]. Due to the rare incidence of idiopathic infarcts, the pathophysiology has not been well studied [ 7 ]. Spontaneous renal artery thrombosis is extremely rare [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Renal Artery Thrombosis Leading to Renal Infarct in a Patient With Recurrent Nephrolithiasis

Vedire¹,

Imburgio²,

Chakrabarti³

et al. 2023

Cureus

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Renal infarction is a rare entity that presents similarly to other common renal conditions such as nephrolithiasis, which can often result in a missed or delayed diagnosis. As a result, a high degree of suspicion for this diagnosis is warranted in patients presenting with flank pain. We present a patient with recurrent nephrolithiasis who presented with flank pain. A subsequent workup revealed a renal infarct due to underlying renal artery thrombosis. We also explore if there was a possible mechanism between this event and his history of recurrent nephrolithiasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Renal Artery Thrombosis Leading to Renal Infarct in a Patient With Recurrent Nephrolithiasis

Vedire¹,

Imburgio²,

Chakrabarti³

et al. 2023

Cureus

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“…The antithrombotic treatment option of RI is determined according to the grade of infarction, suspected occurrence time, and prognosis. 23 24 25 If a patient is suspected to have suffered from remote RI based on clinical and radiologic findings such as atrophic kidney, and if no indication of anticoagulation is found after systemic evaluation, antiplatelet agents could be prescribed. In contrast, anticoagulation therapy should be started when acute or subacute infarctions are suspected based on systemic evaluation or when patients have underlying diseases that raise the embolic risk.…”

Section: Discussionmentioning

confidence: 99%

Temporal Trend of the Incidence and Characteristics of Renal Infarction: Korean Nationwide Population Study

et al. 2023

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Background Large-scale studies about epidemiologic characteristics of renal infarction (RI) are few. In this study, we aimed to analyze the incidence and prevalence of RI with comorbidities in the South Korean population. Methods We investigated the medical history of the entire South Korean adult population between 2013 and 2019 using the National Health Insurance Service database (n = 51,849,591 in 2019). Diagnosis of RI comorbidities were confirmed with International Classification of Disease, Tenth Revision, Clinical Modification codes. Epidemiologic characteristics, distribution of comorbidities according to etiologic mechanisms, and trend of antithrombotic agents were estimated. Results During the 7-years, 10,496 patients were newly diagnosed with RI. The incidence rate increased from 2.68 to 3.06 per 100,000 person-years during the study period. The incidence rate of RI increased with age peaking in the 70s with 1.41 times male predominance. The most common comorbidity was hypertension, followed by dyslipidemia and diabetes mellitus. Regarding etiologic risk factor distribution, high embolic risk group, renovascular disease group, and hypercoagulable state group accounted for 16.6%, 29.1%, and 13.7% on average, respectively. For the antithrombotic treatment of RI, the prescription of antiplatelet agent gradually decreased from 17.0% to 13.0% while that of anticoagulation agent was maintained around 35%. The proportion of non-vitamin K antagonist oral anticoagulants remarkably increased from only 1.4% to 17.6%. Conclusion Considering the progressively increasing incidence of RI and high prevalence of coexisting risk factors, constant efforts to raise awareness of the disease are necessary. The current epidemiologic investigation of RI would be the stepping-stone to establishing future studies about clinical outcomes and optimal treatment strategies.

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“…A few studies have reported resolution of the pulmonary vein stump thrombus and recovery of renal function using sustained anticoagulant therapy [9] , [10] ; however, the role of sustained anticoagulation therapy in patients without confirmed thrombosis remains unclear. A previous study suggested that the efficacy of non-anticoagulation therapy is similar to that of anticoagulation therapy to prevent recurrent or de novo thrombosis after idiopathic renal infarction and that this approach is associated with a lower risk of bleeding [12] . Although anticoagulation therapy was administered for only 7 days in our patient, recurrent renal infarction did not occur.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic renal infarction after left upper lobectomy: Case report

Motono

Ishikawa

Iwai

et al. 2021

International Journal of Surgery Case Reports

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Background Renal infarction after pulmonary resection is relatively rare; however, it is associated with severe morbidity. Case presentation An 80-year-old woman without any severe comorbidity or smoking history underwent left upper lobectomy (LUL) concomitant with mediastinal lymph node dissection for lung adenocarcinoma. She did not show fever, flank pain, and/or nausea; however, laboratory data revealed an elevated white blood cell count (WBC) (13,460 cells/mm 3 ) and elevated serum lactate dehydrogenase (LDH) (670 IU/L) and C-reactive protein (CRP) (23.6 mg/dL) levels on the fifth postoperative day. Contrast-enhanced computed tomography from the thorax to the pelvic cavity revealed a partial defect of the right kidney without any indication of infection and no pulmonary vein stump thrombosis. We diagnosed the patient with partial right renal infarction, and heparin (10,000 IU/day) was initiated. Laboratory data showed gradual reduction in the WBC (7700 cells/mm 3 ), as well as in the serum LDH (355 IU/L) and CRP (0.76 mg/dL) levels, 7 days after heparin initiation. Anticoagulation therapy including heparin administration was discontinued because renal function remained, and we observed no pulmonary vein stump thrombosis. Laboratory data remained within normal limits, and the patient was discharged on postoperative day 15. Conclusions LUL is considered a risk factor for this condition, and elevated WBC, as well as serum LDH and CRP levels are useful diagnostic indicators.

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Idiopathic Renal Infarction and Anticoagulation

Cited by 5 publications

References 15 publications

Renal Artery Thrombosis Leading to Renal Infarct in a Patient With Recurrent Nephrolithiasis

Renal Artery Thrombosis Leading to Renal Infarct in a Patient With Recurrent Nephrolithiasis

Temporal Trend of the Incidence and Characteristics of Renal Infarction: Korean Nationwide Population Study

Asymptomatic renal infarction after left upper lobectomy: Case report

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