Acute renal infarction : Clinical features in 23 cases.
- Author:
Jung Sup KIM
1
;
Sung Yik LEE
;
Jung Hee KIM
;
Eun Hoe KWON
;
Sang Heon SONG
;
Dong Won LEE
;
Soo Bong LEE
;
Ihm Soo KWAK
Author Information
1. Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea. iskwak@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Renal infarction;
Renal failure;
LDH
- MeSH:
Abdominal Pain;
Angiography;
Anorexia;
Busan;
Cardiovascular Diseases;
Creatinine;
Diagnosis;
Early Diagnosis;
Female;
Fever;
Flank Pain;
Hematuria;
Heparin;
Humans;
Hypertension;
Infarction*;
Kidney Transplantation;
Male;
Medical Records;
Nausea;
Neoplastic Cells, Circulating;
Oliguria;
Physical Examination;
Renal Insufficiency;
Thromboembolism;
Thrombosis;
Ultrasonography;
Vasculitis;
Vomiting;
Warfarin
- From:Korean Journal of Medicine
2006;70(5):543-550
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Acute renal infarction is an uncommon disease which is often delyed or missed due to its rarity and unspecific clinical presentation. METHODS: In order to evaluate the clinical features and to elucidate diagnostic or therapeutic options, we analyzed the medical records of 23 patients who were admitted to Pusan National University Hospital from January, 1995 to July, 2004 and diagnosed as renal infarction. RESULTS: The mean age of the patients was 57.3 18.4 years and male to female ratio was 0.91:1. Underlying diseases were cardiovascular disease (n=18), tumor embolism (n=1), vasculitis (n=1), post kidney transplantation thrombosis (n=1), and trauma(n=1). One patient did not have any underlying disease. Initial symptoms were abdominal or flank pain (61%), fever (35%), anorexia (35%), nausea (26%), vomiting (17%), gross hematuria (9%), and oliguria (4%). On physical examination, costovertebral angle tenderness (43%), abdominal tenderness (9%), and hypertension (35%) were noted. Initial abnormal laboratory findings were elevated serum level of LDH (100%), AST (87%), ALT (83%), CK (22%), and creatinine (>1.4 mg/dL, 17%). Imaging diagnosis of renal infarction included renal angiography, isotope renal scan, computed tomography or ultrasonography. CT was done in 17/23 cases and useful in diagnosis of renal infarction. Nine patients were treated with heparin or warfarin. Thrombolysis was done in 3 patients. Others were treated conservatively. CONCLUSIONS: In a patients with an increased risk of thromboembolism, flank or abdominal pain, microscopic hematuria, and an elevated serum LDH are strongly supportive of diagnosis of renal infarction. Under such circumstances, enhanced CT is essential for the early diagnosis of renal infarction.
