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[Embolism in renal artery]
J C Martín Martínez1, J M Díez Cordero, A Echenagusia Belda
1Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Objective:
To describe a useful algorithm when acute non-traumatic renal artery occlusion is suspected.
Methods:
The diagnostic and therapeutic aspects of this uncommon disease are analyzed through two cases that had been managed differently.
Results:
Early clinical suspicion is based upon a non-colic sudden flank pain in patients with a history of cardiac embolic events, increased serum LDH, ALAT and ASAT, proteinuria, non-lithiasic, non-functioning kidney on IVP and a normal sized non-dilated kidney on ultrasound. The next step is diagnostic angiography and fibrinolysis when indicated.
Conclusions:
Intra-arterial fibrinolysis is the treatment of choice in renal artery embolism when functional recovery by angiographic and clinical criteria is present, and will be further enhanced the earlier the diagnosis is made.