Clinical Approach to Renal Artery Thromboembolism

Year 2020, Volume: 5 Issue: 2, 75 - 78, 31.08.2020

İbrahim Kartal , Okan Alkış , Mustafa Baturay Çetinkaya Sinan Çelen , Bekir Aras

https://doi.org/10.25000/acem.761573

Abstract

Objective: We aimed to reveal the clinical, laboratory, radiological findings of infarction in the renal artery and its branches due to thrombosis, its effects on renal functions and the measures to be taken.
Materials and Methods: The study sample included 8 patients who were admitted to the emergency department of Kutahya University of Health Sciences Evliya Celebi Training and Research Hospital between 2018-2020, and who were hospitalized with the diagnosis of acute renal infarction. Patients were retrospectively analyzed with clinical findings, CT angiography-abdomen, clinical observations, prognosis and complications.
Results: Of the patients, 5 were male and 3 were female. The mean age was 55.13 (29-69) years. One patient presented with bilateral renal infarction, while 7 had unilateral renal infarction. The etiology of the patients was idiopathic in 2, atrial fibrilation (AF) in 3 patients, and atherosclerosis in 3 patient. The mean serum creatinine of 1.24 (0.7-3.2) mg/dl and the mean blood leukocyte level of 16925 (11000-26000) mcL were determined. The mean length of hospital stay was 4.6 (3-7) days. Anticoagulant therapy was initiated in all patients for risk of recurrent renal infarction and thromboembolism.
Conclusion: We revealed that renal infarction, rarely seen in urology practice, has nonspecific clinical findings; therefore, it should be kept in mind in differential diagnosis for patients presenting with sudden-onset oblique or abdominal pain, and that diagnosis can be made using contrast-enhanced CT. We determined that AF and valvular heart diseases which cause atherosclerosis and cardiac thrombosis play an important role in the etiology.

Keywords

abdominal pain, computed tomography angiography, infarction, renal artery, thromboembolism

References

• 1.Domanovits H, Paulis M, Nikfardjam M, Meron G, Kurkciyan I, Bankier AA, et al. Acute renal infarction. Clinical characteristics of 17 patients. Medicine (Baltimore). 1999;78(6):386-94.
• 2.Korzets Z, Plotkin E, Bernheim J, Zissin R. The clinical spectrum of acute renal infarction. Isr Med Assoc J. 2002;4(10):781-4.
• 3.Nagasawa T, Matsuda K, Takeuchi Y, Fukami H, Sato H, Saito A, et al. A case series of acute renal infarction at a single center in Japan. Clin Exp Nephrol. 2016;20(3):411-5.
• 4.Mesiano P, Rollino C, Beltrame G, Ferro M, Quattrocchio G, Fenoglio R, et al. Acute renal infarction: a single center experience. J Nephrol. 2017;30(1):103-7.
• 5.Huang CC, Lo HC, Huang HH, Kao WF, Yen DH, Wang LM, et al. ED presentations of acute renal infarction. Am J Emerg Med. 2007;25(2):164-9.
• 6.Nandwani A, Pathania D, Jha PK, Kher V. Renal Artery Thrombosis with Renal Infarction: A Rare Cause of Acute Abdomen. Indian J Nephrol. 2017;27(4):313-5.
• 7.Suzer O, Shirkhoda A, Jafri SZ, Madrazo BL, Bis KG, Mastromatteo JF. CT features of renal infarction. Eur J Radiol. 2002;44(1):59-64.
• 8.Zhang ZG, Liu XM. [Clinical characteristics of patients with acute renal infarction: an analysis of 52 patients in a single center]. Beijing Da Xue Xue Bao Yi Xue Ban. 2019;51(5):863-9.
• 9.Hazanov N, Somin M, Attali M, Beilinson N, Thaler M, Mouallem M, et al. Acute renal embolism. Forty-four cases of renal infarction in patients with atrial fibrillation. Medicine (Baltimore). 2004;83(5):292-9.
• 10.Rhee H, Song SH, Won Lee D, Lee SB, Kwak IS, Seong EY. The significance of clinical features in the prognosis of acute renal infarction: single center experience. Clin Exp Nephrol. 2012;16(4):611-6.
• 11.Ongun S, Bozkurt O, Demir O, Cimen S, Aslan G. Midterm renal functions following acute renal infarction. Kaohsiung J Med Sci. 2015;31(10):529-33.
• 12.Bae EJ, Hwang K, Jang HN, Kim MJ, Jeon DH, Kim HJ, et al. A retrospective study of short- and long-term effects on renal function after acute renal infarction. Ren Fail. 2014;36(9):1385-9.
• 13.Kagaya S, Yoshie O, Fukami H, Sato H, Saito A, Takeuchi Y, et al. Renal infarct volume and renal function decline in acute and chronic phases. Clin Exp Nephrol. 2017;21(6):1030-4.
• 14.Eren N, Gungor O, Kocyigit I, Guzel FB, Erken E, Altunoren O, et al. Acute renal infarction in Turkey: a review of 121 cases. Int Urol Nephrol. 2018;50(11):2067-72.
• 15.Tascon GC, Chiriboga DES, Ramos RL, Diaz Diaz D, Ruiz CR, Procaccini FL, et al. [Renal infarction in a patient with active COVID -19 infection]. Nefrologia. 2020.