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Traumatic bilateral renal infarction.

N E Peterson1

  • 1Department of Surgery, Denver General Hospital, CO 80204-4507.

The Journal of Trauma
|February 1, 1989
PubMed
Summary
This summary is machine-generated.

Renal artery thrombosis can lead to kidney infarction, but some cases show patchy viability, suggesting potential for recovery. Avoid immediate nephrectomy, as delayed intervention or revascularization may be viable options.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Pathology

Background:

  • Renal artery thrombosis often leads to nephrectomy, limiting study of spontaneous recovery.
  • Histologic evidence of patchy viability exists in some renal artery thrombosis/embolization cases.

Purpose of the Study:

  • To investigate the potential for spontaneous renal function recovery after renal artery thrombosis.
  • To evaluate the implications of preserving kidneys with potential for recovery versus immediate nephrectomy.

Main Methods:

  • Literature review of renal artery thrombosis and embolization cases.
  • Analysis of histologic findings in kidneys subjected to nephrectomy or autopsy versus those with documented patchy viability.

Main Results:

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  • Some cases of renal artery thrombosis/embolization show patchy histologic viability, suggesting potential for recovery.
  • Majority of kidneys with sustained arterial interruption undergo infarction; a subgroup may develop hypertension.
  • Potential for misdiagnosis with renal cortical necrosis, which can spontaneously recover.

Conclusions:

  • Immediate bilateral nephrectomy for renal artery thrombosis may be unjustified due to potential for recovery.
  • Delayed nephrectomy remains an option; native kidney retention offers metabolic benefits.
  • Consideration for secondary revascularization in spontaneously recovered kidneys, balanced against risks of hyperfiltration and iatrogenic complications.