Long-Term Follow-Up Results of Acute Renal Embolism after Anticoagulation Therapy

Yun, Woo‐Sung

doi:10.1016/j.avsg.2014.09.028

Cited by 15 publications

(26 citation statements)

References 14 publications

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“…Infarctions in other organs that were observed in 10 of our patients at the time of diagnosis, and in 7 additional patients thereafter, were associated with more than 1 risk factor in our patients (including cancer plus each of atrial fibrillation, endocarditis, hypertension, DM, malaria, or cerebral infarction history, as well as DM plus a postoperative immobilization state). Intensive anticoagulation therapy and careful probing for underlying disease may be required to prevent concomitant adverse thromboembolic events as suggested by Yun [10] ; however, this could result in more adverse outcomes in certain patients such as those with cancer. Infarctions in other organs are not associated with renal function change.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal or flank pain is a common clinical manifestation, although some patients do not experience any subjective symptoms. Therefore, RI is difficult to detect unless a clinician specifically checks for its presence and is thus likely to be underdiagnosed [1] , [3] , [4] , [10] , [11] , [12] . Postmortem examinations in 1 study revealed that the incidence of RI was 1.4% (205 of 14,411) with only 2 of these cases having been clinically diagnosed antemortem [13] .…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and outcomes of acute renal infarction

Yang

Lee

et al. 2016

Kidney Research and Clinical Practice

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BackgroundRenal infarction (RI) is an uncommon disease that is difficult to diagnose. As little is known about clinical characteristics of this disease, we investigated its underlying risk factors and outcomes.MethodsWe performed a retrospective single-center study of 89 patients newly diagnosed with acute RI between January 2002 and March 2015 using imaging modalities. Clinical features, possible etiologies, and long-term renal outcome data were reviewed.ResultsThe patients' mean age was 63.5 ± 15.42 years; 23.6% had diabetes and 56.2% had hypertension. Unilateral and bilateral involvements were shown in 80.9% and 19.1% of patients, respectively; proteinuria and hematuria were reported in 40.4% and 41.6%, respectively. Cardiovascular disease was the most common underlying disease, followed by renal vascular injury and hypercoagulability disorder. Fourteen patients had no specific underlying disease. At the time of diagnosis, acute kidney injury (AKI) was found in 34.8% of patients. Univariate analysis revealed diabetes mellitus (DM), leukocytosis, and high C-reactive protein (CRP) as significant risk factors for the development of AKI. On multivariate analysis, DM and high CRP levels were independent predictors for AKI. During follow-up, chronic kidney disease developed in 27.4% of patients. Univariate and multivariate Cox regression analyses showed old age to be an independent risk factor for this disease, whereas AKI history was a negative risk factor.ConclusionDM patients or those with high CRP levels should be observed for renal function deterioration. Clinicians should also monitor for RI in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors and outcomes of acute renal infarction

Yang

Lee

et al. 2016

Kidney Research and Clinical Practice

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“…The role of anticoagulation in patients with cryptogenic renal infarctions is less clear. Recurrence of infarction was evident in 17% of 47 patients with renal infarction in one retrospective analysis . Consideration of indefinite anticoagulation in these patients seems warranted given the high risk of recurrence off anticoagulation.…”

Section: Renal Infarctionmentioning

confidence: 99%

mentioning

confidence: 97%

Arterial thrombosis in unusual sites: A practical review

O’Donnell

Shatzel

Olson

et al. 2018

European J of Haematology

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While common forms of arterial disease such as stroke and myocardial infarction are well studied and appropriate treatment algorithms are well described, occasionally, practitioners will encounter patients with thrombosis in other arteries; the cause and treatment of which is not entirely obvious or well studied. In this section, we will review the current data on arterial thrombosis, describing anatomic sources and hypercoagulable associations, and outline the epidemiology, pathophysiology, clinical presentation, etiology, and treatment of intracardiac thrombus, primary aortic mural thrombus, visceral infarctions, and cryptogenic limb ischemia. (Table 1). | ARTERIAL THROMBOS IS-ANATOMIC CONS IDER ATIONSArterial thrombosis most often occurs in association with atherosclerosis. In cryptogenic cases, arterial thrombosis may result from an anatomic source, the most common of which is cardioembolic, such as intracardiac thrombus, atrial appendage thrombus, patent foramen ovale with paradoxical embolus, and valvular vegetation.The minimal workup we consider in truly cryptogenic cases is assessment for a cardioembolic source ( Figure 1) including a transthoracic echocardiogram in conjunction with injection of agitated saline contrast and color Doppler imaging in order to detect a patent foramen ovale. Due to the unique nature of intracardiac thrombi and primary aortic mural thrombi, the following sections will outline the epidemiology, etiology, and management of these entities. | INTR AC ARD IAC THROMB ILeft ventricular (LV) thrombus most commonly occur after myocar- K E Y W O R D Sarterial thrombosis, coagulation disorder, hypercoagulable, infarction

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“…The lack of guideline is an issue, considering the high recurrence of cardiovascular events and the poor prognosis of the disease. In retrospective studies, patients with RI have an all-cause mortality rate of 19.7% at 40 months [ 1 ], despite a rare evolution to dialysis or end-stage renal disease (2% at 41 months [ 2 ]). This means that the poor prognosis is not due to the severity of the kidney injury, but mainly to cardiovascular events and patients’ comorbidities with an outcome rate of 12% at 48 months [ 3 ], highlighting the need of an appropriate secondary prevention treatment.…”

Section: Introductionmentioning

confidence: 99%

Renal arteriography with endovascular ultrasound for the management of renal infarction patients

et al. 2020

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Background Renal infarction (RI) is a rare disease with poor prognosis. Appropriate secondary prevention treatment is essential and requires an exhaustive etiological assessment. We aimed to determine whether invasive endovascular explorations may improve the diagnostic process and change the secondary prevention treatment strategy in RI patients. Methods We report a retrospective observational study of 25 RI patients referred to Tours University Hospital between 2011 and 2018 for etiological investigation including renal arteriography and intravascular ultrasonography (IVUS). We sought for antithrombotic treatment regimen, vital status, bleeding and ischemic outcomes during the median follow-up of 59 months. Results Invasive explorations showed local arterial disease in 14 patients (56%). This led to a diagnosis or change in diagnosis in 9 patients (36%) and to a change in antithrombotic strategy in 56% of cases, with an increased prescription of antiplatelet therapy. No patient died, only two patients (8%) had persistent mild renal insufficiency. One IVUS complication was reported and treated without any significant long-term consequences. Conclusion Invasive endovascular investigations of RI may modify the secondary prevention treatment through a better assessment of the aetiology of RI. Multicentric randomized studies are necessary to advocate the hypothesis that invasive exploration of renal artery can improve long-term prognosis.

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Long-Term Follow-Up Results of Acute Renal Embolism after Anticoagulation Therapy

Cited by 15 publications

References 14 publications

Risk factors and outcomes of acute renal infarction

Risk factors and outcomes of acute renal infarction

Arterial thrombosis in unusual sites: A practical review

Renal arteriography with endovascular ultrasound for the management of renal infarction patients

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