Clinical Characteristics of Nontraumatic Acute Renal Infarction

Ahn, Byung Cheol; Kim, Se Joong; Ahn, Hyun Soo

Abstract

Purpose
Early diagnosis and treatment are essential features to save the kidney in patients with an acute renal infarction. To reduce the delay in diagnosis, the clinical features and treatments of an acute renal infarction were evaluated.
Materials and Methods
The medical records of 19 patients (14 men and 5 women) diagnosed with an acute renal infarction were retrospectively analyzed. Symptoms, findings of a cardiologic evaluation, laboratory findings, presumptive diagnosis and treatments were evaluated.
Results
All patients complained of flank or abdominal pain. Fifty-three percent of the patients had a history of cardiovascular disease and 37% had no history of specific illnesses. The level of serum LDH was markedly elevated in all patients that performed the test. Initially, only 4 patients were diagnosed as acute renal infarction. In the others, the presumptive diagnoses were urinary stone, acute abdomen, aortic dissection and so forth. Seven patients were managed with conservative care due to the delay in diagnosis or poor general condition. Nine patients were managed with systemic anticoagulation and 3 with intra-arterial thrombolytic therapy.
Conclusions
An acute renal infarction must be considered as one of the presumptive diagnoses in patients presenting with flank or abdominal pain and a history of cardiovascular diseases. Prompt CT scanning and testing of the serum LDH level will help in the accurate and immediate diagnosis of an acute renal infarction.