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[Blue toes and kidney insufficiency]
1Martini Ziekenhuis, locatie Van Swieten, afd. Interne Geneeskunde, Groningen.
Insights
Cholesterol crystal embolisation can cause kidney problems and purple toes, especially after medical procedures. Increased awareness of these symptoms is crucial due to rising intravascular procedure use.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Context:
- Cholesterol crystal embolisation is a rare but serious complication.
- Patients with hypertension and coronary artery disease are at higher risk.
- Intravascular procedures can trigger cholesterol emboli.
Purpose:
- To report three cases of cholesterol crystal embolisation.
- To highlight the association between invasive procedures and this syndrome.
- To emphasize the importance of recognizing early symptoms.
Summary:
- Three patients (two female, one male) with pre-existing cardiovascular conditions developed renal insufficiency and purple toes.
- Cholesterol crystal embolisation was confirmed as the cause.
- In two cases, invasive procedures (femoropopliteal bypass, aortic valve replacement) precipitated the embolisation.
Impact:
- Increased awareness of purple toes as a symptom of cholesterol crystal embolisation is vital.
- Early recognition can prevent severe complications like renal failure.
- The rising use of intravascular procedures necessitates vigilance for this syndrome.
Abstract:
Three patients, two women aged 73 and 70 and one man aged 58 years, were known with hypertension and (or) coronary disease. They developed renal insufficiency and purple toes due to cholesterol crystal embolisation. In two of the three patients invasive procedures (femoropopliteal bypass surgery and replacement of the aortic valve, respectively) had provoked the embolisation process. Growing awareness of symptoms such as purple toes is important as the increasing use of intravascular procedures will lead to higher incidence of this syndrome with renal insufficiency as the most severe clinical complication.