Sequelae after Treatment of Acute Renal Infarction

Lee, Ho Chul; Jung, Jin Hyang; Huh, Seung; Kim, Young Wook

Abstract

PURPOSE: Acute renal infarction is relatively rare disease showing variable clinical manifestations according to the extent of renal parenchymal involvement. We reviewed the clinical features of acute renal infarction and attempted to observe the late sequelae of renal infarction. METHOD: From 1994 to 2001, 12 patients with acute renal infarction were treated at Division of Vascular Surgery, Kyung-pook National University Hospital, Daegu, Korea. They were 9 male and 3 female patients with mean age of 47 years (17 to 77 years). We retrospectively reviewed their clinical features and followed up late status of renal function and blood pressure. RESULT: The causes of renal infarction were arterial embolism in 7 and trauma in 5 patient. Among 14 kidneys involving bilateral renal involvement in 2 patients, 8 kidneys revealed partial renal infarction and 6 kidneys revealed total renal infarction. Abdominal and/or flank pain developed in all patients. Contrast enhanced abdominal CT, and aortography were used to confirm the diagnosis of acute renal infarction. Four patients underwent surgical treatment (1 renal artery embolectomy, 2 renal artery bypass, 1 nephrectomy) and others were treated conservatively including anticoagulaton for the patients with embolism. During the follow-up period, we found 4 (33.3%) late renal functional impairment and 3 (25%) newly developed hypertension to persist.
CONCLUSION
Two common causes of acute renal infarction were arterial embolism and abdominal trauma. After treatment of 12 patients with acute renal infarction involving 14 kidneys, we observed renal impairment and/or hypertension to persist even in the patient suffered from partial renal infarction.