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Atheroembolic renal disease with rapid progression and fatal outcome

Bernardo Faria1, Joana Vidinha, Cátia Pêgo

  • 1Nephrology and Dialysis Unit, Hospital São Teotónio-Viseu, Av Rei Dom Duarte, 3504 509 Viseu, Portugal. faria_bernardo@yahoo.com

Clinical and Experimental Nephrology
|November 12, 2010
PubMed

Insights

Atheroembolic renal disease, caused by cholesterol crystals, is often underdiagnosed and has a poor prognosis. This case highlights a multisystemic presentation resistant to treatment, emphasizing the need for better diagnostic and therapeutic strategies.

Area of Science:

  • Nephrology
  • Cardiology
  • Pathology

Background:

  • Atheroembolic renal disease (AERD) results from cholesterol emboli lodging in renal microvasculature.
  • It is frequently associated with vascular procedures and anticoagulation, often presenting with poor prognosis.
  • Steroid therapy and aggressive prevention of embolic events may improve survival.

Observation:

  • A patient developed multisystemic AERD following percutaneous coronary intervention and anticoagulation for myocardial infarction.
  • Manifestations included renal, cutaneous, ophthalmic, neurological, and potential muscular and mesenteric involvement.
  • Despite corticosteroids and anticoagulation cessation, the patient rapidly progressed to end-stage renal disease.

Findings:

  • The case demonstrated a catastrophic and treatment-resistant progression of Atheroembolic renal disease.
  • Multisystemic involvement complicated the clinical presentation and management.
  • Rapid decline to end-stage renal disease and mortality occurred within six months.

Implications:

  • There is a critical need for improved diagnostic protocols for Atheroembolic renal disease.
  • Development of more effective preventive and therapeutic strategies is essential.
  • Further research into managing this aggressive condition is warranted.

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