Renal infarction in the ED: 10-year experience and review of the literature

Antopolsky, Meir; Simanovsky, Natalia; Stalnikowicz, Ruth; Salameh, Shaden; Hiller, Nurith

doi:10.1016/j.ajem.2011.06.041

Cited by 150 publications

(170 citation statements)

References 8 publications

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“…Clinical suspicion of other common diseases, in particular acute pyelonephritis and nephrolithiasis, may delay the diagnosis. Indeed, using an unenhanced CT scan to rule out urolithiasis, renal infarction may be missed [6]. Thirty-five percent of our patients underwent more than one CT during a brief period of observation.…”

Section: Resultsmentioning

confidence: 99%

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Acute renal infarction: a single center experience

et al. 2016

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Background Acute renal infarction is a rare condition whose diagnosis is often delayed. Major risk factors include atrial fibrillation, valvular or ischemic heart disease, renal artery thrombosis/dissection and coagulopathy. MethodsWe reviewed the medical records of 18 patients admitted to our Nephrology Department between 1999 and 2015 for acute renal infarction diagnosed by computed tomography. Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy was performed in some patients during follow-up to assess parenchymal lesions and estimate differential kidney function. ResultsMean age was 59.8 years. Major associated risk factors included hypertension (44 %), obesity (33 %), atrial fibrillation (28 %), peripheral vascular disease (17 %), smoking (17 %), prior thromboembolic event (11 %), diabetes (11 %), estroprogestinic therapy (11 %). Seventy-two percent of patients presented with flank pain. Mean serum creatinine was 1.2 ± 0.6 mg/dl. Acute kidney injury occurred as the initial manifestation in two patients. Patients were managed conservatively, with low molecular weight heparin (83 %) or aspirin (11 %). At the end of follow-up serum creatinine was 1.1 ± 0.3 mg/dl; one patient remained on chronic hemodialysis. 58 % of patients who underwent renal scintigraphy after a median of 8 months had a reduced contribution of the previously affected kidney to total renal function. ConclusionRisk factors associated with the development of chronic kidney disease following renal infarction are unknown. In our subjects, renal function remained stable in all but one patient who developed end stage renal disease. Further studies should focus on etiology and evolution of kidney function in patients with acute renal infarction. IntroductionAcute renal infarction, due to an abrupt interruption of renal arterial flow, is a rare condition with an estimated incidence of 0.004-0.007 % in the Emergency Department setting [1,2]. 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]. 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.

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Section: Resultsmentioning

confidence: 99%

“…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.…”

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confidence: 99%

Acute renal infarction: a single center experience

et al. 2016

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“…12 However, these studies only described the characteristics of renal infarction and did not focus on renal function as affected by renal infarction. In addition, because they did not consider baseline renal function, the definitions of acute renal impairment and chronic renal disease were ambiguous.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of short- and long-term effects on renal function after acute renal infarction

Bae

Hwang²,

Jang³

et al. 2014

Renal Failure

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“…Renal artery thromboembolism causing persistent and unexplained flank pain or abdominal pain mimicking renal calculus and pyelonephritis. Therefore, raised LDH, haematuria, leucocytosis along with radiological modality of computed tomography supports diagnosis of early renal arterial thrombosis and infarction (2). In the context of inexplicable abdominal and flank pain emergency and acute physician should consider renal artery thrombosis in background of risk factors associated to this clinical scenario.…”

Section: Introductionmentioning

confidence: 99%

An Ambiguous Case of Abdominal Pain involving Renal Artery Thrombosis with Renal Infarction

Almamun¹,

Munir²,

Raza³

et al. 2018

Preprint

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Renal artery thrombosis is a sporadic serious clinical condition which potentially cause renal infarction. Diagnosis of renal infarction can be delayed or missed due to non specific clinical presentation and overlapping appearance of medical and surgical phenomena. Early diagnosis supported by biochemical and radiological findings while appropriate management potentially improve morbidity and mortality. Persistent abdominal or flank pain with raised LDH and proteinuria on background of thromboembolism risk factors supports the diagnosis. Despite the rarity of the disease rapid identification with prompt medical or endovascular intervention could prevent irreversible renal parenchymal damage.

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Renal infarction in the ED: 10-year experience and review of the literature

Cited by 150 publications

References 8 publications

Acute renal infarction: a single center experience

Acute renal infarction: a single center experience

A retrospective study of short- and long-term effects on renal function after acute renal infarction

An Ambiguous Case of Abdominal Pain involving Renal Artery Thrombosis with Renal Infarction

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