Renal infarct

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

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Diagnosis

History and Symptoms

The patient may compain of persistent flank pain, low back pain or even abdominal pain.

There is usually a history of thormboembolic risk factors (cancer) or a prior history of embolization. Atherosclerotic risk factors are often present.

Risk factors

• Coagulopathy
• Cocaine
• Ehlers-Danlos syndrome
• Fibromuscular dysplasia
• Marfan syndrome
• Renal transplant
• Stent placement
• Trauma

Laboratory Findings

Urinalysis

Hematuria is present in 74% of cases

Blood

Elevated LDH is sensitive but non-specific for renal infarction.

Imaging Studies

The diagnostic study of choice is a contrast CT. Ultrasound can evaluate if obstructive uropathy is present as a cause of back pain and renal insufficiency, but it lacks senstitivity in the detection of renal infarction.

Treatment

Prompt recognition is critical so that thrombolysis, anticoagulation, or embolectomy can be undertaken to minimize the loss in renal function. It should be noted that these patients are at high risk of recurrent thromboembolism, and long-term anticoagulation may be of benefit.