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[Renal artery embolism].

Alvaro de Pablo Cárdenas1, Miguel Angel Pinós Paul, Javier Ignacio Jiménez Aristu

  • 1Servicio de Urología, Hospital Virgen del Camino, España.

Archivos Espanoles De Urologia
|March 4, 2003
PubMed
Summary

Renal artery embolism is a rare urologic emergency. Successful fibrinolytic therapy was achieved in a patient with cardiovascular disease presenting with flank pain, highlighting early diagnosis and treatment importance.

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Area of Science:

  • Urology
  • Vascular Surgery
  • Nephrology

Background:

  • Renal artery embolism is an uncommon, non-traumatic vascular emergency.
  • Often associated with underlying emboligenous heart disease, such as atrial fibrillation with mitral stenosis.

Observation:

  • A 47-year-old male with cardiovascular disease presented with acute left flank pain.
  • Radiological studies, including IVP and ultrasound, suggested renal vascular disease over obstruction.
  • Arteriography confirmed left renal artery embolism.

Findings:

  • Fibrinolytic therapy was successful in treating the renal artery embolism.
  • Diagnosis relies on imaging (ultrasound, IVP) and arteriography.
  • Laboratory findings may include hematuria, pyuria, proteinuria, leukocytosis, elevated LDH, GOT, and alkaline phosphatase, with variable renal impairment.

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Implications:

  • Early diagnosis and intra-arterial fibrinolysis are crucial for preserving renal function.
  • Surgery is reserved for cases where renal function is critically endangered.
  • Potential complications include renovascular hypertension and renal failure.