Recovery of function in a solitary kidney after intra-arterial thrombolytic therapy

Renal artery thromboembolism is a rare event that most often occurs in patients with cardiac dysrhythmias. Surgical thromboembolectomy is risky and medical therapy with intra-arterial thrombolytic agents has become increasingly popular. Although successful clot dissolution has been well documented, renal function often is not recovered. We describe a patient with anuria from thromboembolism to a solitary kidney, treated with low dose intra-arterial streptokinase infusion. There were no adverse effects from therapy and renal function returned to a point where dialysis was no longer required. A review of the literature is included with special attention to various protocols for infusion. Early diagnosis and prompt initiation of therapy may result in clinically significant recovery of renal function.