Renal infarct

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Overview

Diagnosis

History and Symptoms

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

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

Risk factors for renal infarction include the following:

Coagulopathy

Cocaine

Ehlers-Danlos syndrome

Fibromuscular dysplasia

Marfan syndrome

Renal transplant

Stent placement

Trauma

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.

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.

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .