Renal infarct

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk factors

• Coagulopathy
• Cocaine
• Ehlers-Danlos syndrome
• Fibromuscular dysplasia
• Marfan syndrome
• Renal transplant
• Stent placement
• Trauma

Diagnosis

History

There is usually a history of thromboembolic risk factors (cancer) or a prior history of embolization. Atherosclerotic risk factors are often present.

Symptoms

The patient may compain of persistent flank pain, low back pain or even abdominal pain.

Laboratory Findings

Urinalysis

Hematuria is present in 74% of cases

Blood

Elevated LDH is sensitive but non-specific for renal infarction.

Imaging Studies

The diagnostic study of choice is a contrast CT. Ultrasound can evaluate if obstructive uropathy is present as a cause of back pain and renal insufficiency, but it lacks senstitivity in the detection of renal infarction.

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  CT demonstrates a left renal infarction patient#1 Image courtesy of RadsWiki and copylefted

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  CT demonstrates a left renal infarction patient#1 Image courtesy of RadsWiki and copylefted

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  CT demonstrates a left renal infarction patient#1 Image courtesy of RadsWiki and copylefted

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  CT demonstrates a right renal infarction patient#2 Image courtesy of RadsWiki and copylefted

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  CT demonstrates a right renal infarction patient#2 Image courtesy of RadsWiki and copylefted

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  CT demonstrates a right renal infarction patient#2 Image courtesy of RadsWiki and copylefted

Treatment

Prompt recognition is critical so that thrombolysis, anticoagulation, or embolectomy can be undertaken to minimize the loss in renal function. It should be noted that these patients are at high risk of recurrent thromboembolism, and long-term anticoagulation may be of benefit.