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Renal artery dissection following marathon running.
Fahad M Iqbal1, Madhavi Goparaju, Soumya Yemme
1Department of Internal Medicine, St Joseph Hospital, 2900 N Lake Shore Drive, Chicago, IL 60657, USA. fmiqbal@sbcglobal.net
Angiology
|February 5, 2009
Summary
Renal artery dissection can occur in healthy men after extreme exertion, often missed initially. Conservative management is typical unless hypertension or declining kidney function develops, with good outcomes.
Area of Science:
- Nephrology
- Vascular Surgery
- Sports Medicine
Background:
- Renal artery dissection (RAD) is a rare condition, often presenting with flank pain.
- It can be challenging to diagnose, especially in otherwise healthy individuals.
Observation:
- A previously healthy 38-year-old man developed flank pain post-marathon.
- Imaging revealed kidney infarction but initially no clear dissection.
- Angiography confirmed a segmental renal artery dissection.
Findings:
- The patient remained normotensive with normal renal function and pain resolution.
- RAD in healthy men is often undiagnosed and may be linked to extreme physical exertion.
- Conservative management is effective unless hypertension or renal function decline occurs.
Implications:
- This case highlights the importance of considering RAD in young, healthy individuals with unexplained flank pain after strenuous activity.
- Early diagnosis and conservative management generally lead to excellent prognoses.
- Physicians should discuss risks of extreme exertion with patients.
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