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Related Experiment Videos

Idiopathic renal infarction.

Rob Bolderman1, Raymond Oyen, Anton Verrijcken

  • 1Department of General Internal Medicine, University Hospital, Leuven, Belgium.

The American Journal of Medicine
|March 28, 2006
PubMed
Summary

Acute renal infarction can affect younger individuals without cardiac disease. Consider renal infarction in patients with unexplained renal colic, especially with elevated lactate dehydrogenase, even without atrial fibrillation.

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Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Renal infarction is often underrecognized, with cardioembolism (e.g., atrial fibrillation) traditionally cited as the primary cause.
  • Increased use of contrast-enhanced computed tomography (CT) for acute abdomen may reveal a broader spectrum of renal infarction cases.

Purpose of the Study:

  • To investigate the clinical characteristics and risk factors of acute renal infarction.
  • To determine the prevalence of cardiac disease in patients with CT-documented renal infarction.

Main Methods:

  • A study of 27 consecutive patients with nontraumatic, CT-documented acute renal infarction at a university hospital.
  • Patients were stratified based on the presence or absence of cardiac disease identified during evaluation.

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Main Results:

  • 41% of patients had evident cardiac disease, predominantly atrial fibrillation.
  • 59% of patients had no identifiable cardiac disease (idiopathic group) and were significantly younger with fewer cardiovascular risk factors.
  • Idiopathic group median age was 48 years compared to 75 years in the cardiac disease group (P = .003).

Conclusions:

  • Acute renal infarction can occur in middle-aged individuals lacking cardioembolic risk factors.
  • Renal infarction should be suspected in patients presenting with renal colic without kidney stones, particularly if serum lactate dehydrogenase is elevated, even without a history of atrial fibrillation.