Midterm renal functions following acute renal infarction

Area of Science:

• Nephrology
• Cardiology
• Radiology

Background:

• Renal infarction (RI) is a rare condition often presenting with non-specific symptoms.
• Understanding clinical features and treatment outcomes is essential for patient management.
• Midterm renal function assessment is critical for evaluating the long-term impact of RI.

Purpose of the Study:

• To investigate clinical features of renal infarction (RI) relevant to diagnosis and treatment.
• To evaluate midterm renal function in patients with acute RI.
• To correlate treatment strategies with infarct characteristics and patient outcomes.

Main Methods:

• Retrospective review of medical records for 23 patients diagnosed with acute RI via contrast-enhanced computed tomography (CT) between 1998 and 2012.
• Analysis of descriptive data, clinical signs, symptoms, etiologic factors, laboratory findings, and treatments.
• Renal function assessed using Estimated Glomerular Filtration Rate (eGFR) calculated by the Modification of Diet in Renal Disease (MDRD) formula.

Main Results:

• Atrial fibrillation (AF) was the most common etiologic factor (60.8%).
• Elevated serum lactate dehydrogenase (LDH) (86.9%), leukocytosis (78.2%), and microscopic hematuria (69.5%) were frequent at presentation.
• Mean eGFR improved from 70.8 mL/min/1.73 m² at admission to 82.3 mL/min/1.73 m² at 1-year follow-up.

Conclusions:

• RI should be suspected in patients with persistent flank/abdominal pain, especially those at high risk for thromboembolism.
• Both antiplatelet (e.g., acetylsalicylic acid) and anticoagulant therapies are effective for preserving kidney function, depending on infarct severity.
• Prompt diagnosis and appropriate treatment can lead to improved midterm renal function in RI patients.