Radiologic and Laboratory Characteristics of Acute Renal Infarction in the Emergency Department

Kim, Hoon; Ryu, Seung; Yoo, In Sool

Abstract

PURPOSE
Renal infarction is one of the uncommon causes of acute abdominal pain, and it is often difficult to make a clinical diagnosis. This study was designed to investigate clinical predictors of the acute renal infarction and to suggest useful diagnostic tools to use in the emergency department(ED).
METHODS
We reviewed medical records of the patients with a final diagnosis of acute renal infarction, which was confirmed by contrast-enhanced computed tomography (CT) scan or angiography of the abdomen between Jan. 1998 and Dec. 2000.
RESULTS
Among 24 patients with acute nontraumatic renal infarction, 17 patients (71.0%) had a thromboembolic disease. A number of patients presented with nonspecific abdominal pain. 23 patients (95.8%) had elevated serum LDH after 24 hours of presention. On initial urinalysis, 75.0% of patients (18/24) showed hematuria.
CONCLUSION
This study suggests that the patients with pain in the flank or the abdomen or the low back area should be performed a contrast-enhanced CT scan as soon as possible to rule out the possibility of acute renal infaction, especially when the patient has the high-risk triad of thromboembolism, elevated serum LDH, and hematuria.