The Clininal Characteristics of 26 Patients with Acute Renal Infarction

Choi, Dae Eun; Lee, Sang Ju; Chang, Youn Kyoung; Na, Ki Ryang; Lee, Kang Wook; Shin, Young Tai

Abstract

BACKGROUND
Renal infarction is an infrequent but one of the important causes of functional renal loss. However, due to its rarity and nonspecific presentation, clinical diagnosis is often delayed and occasionally missed. Furthermore, proper therapeutic intervention is not well established yet. We studied clinical feature of renal infarction, factors that related with renal function. METHODS: In order to evaluate the clinical characteristics and renal functional outcome of the patients with acute renal infarction, we analyzed the medical records of 26 patients who were diagnosed as renal infarction and admitted to Chungnam National University Hospital From March, 1995 to April, 2002. RESULTS: The median age of the patients was 47 years (range 4-75) and male to female ratio was 2.7: 1. Underlying diseases of the patients with acute renal infarction were cardiovascular disease (n=16), trauma (n=4), and systemic lupus erythematosus (n= 1). However, five patients did not have any underlying diseases. Initial presenting symptoms and signs were severe tenderness on costovertebral angle (100 %), abdominal or flank pain (73%), gastrointestinal symptoms (30%), fever (27%) and gross hematuria (15%). Initial abnormal laboratory findings were elevated serum level of LDH (100%), AST (81%), ALT (91%), CK (40%) and creatinine (>1.4 mg/dL, 42%) and were hematuria (62%) and proteinuria (38%). Maximal value of serum creatinine level was positively correlated with the magnitude of renal infarction area on abdominal CT and serum LDH level (p<0.05). Twelve patients who were normotensive previously, presented hypertension. Most patients with elevated serum creatinine level initially recovered. However, the renal dysfunction progressed in patients showing more than 50% of renal infarction area on abdominal CT. CONCLUSION: There were underlying conditions in most of acute renal infarction. However, there was no specific underlying condition in 5 patients out of 26 patients with acute renal infarction. The magnitude of renal infarction (> or =25%), elevated serum LDH, proteinuria were significantly correlated with maximal value of serum creatinine level.