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Kim DE, Moon I, Park S, Park M, Park S, Kwon SS, Kong MG, Park HW, Choi HO, Seo HS, Cho YH, Lee NH, Suh J. Temporal Trend of the Incidence and Characteristics of Renal Infarction: Korean Nationwide Population Study. J Korean Med Sci 2023; 38:e239. [PMID: 37550807 PMCID: PMC10412037 DOI: 10.3346/jkms.2023.38.e239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/04/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Large-scale studies about epidemiologic characteristics of renal infarction (RI) are few. In this study, we aimed to analyze the incidence and prevalence of RI with comorbidities in the South Korean population. METHODS We investigated the medical history of the entire South Korean adult population between 2013 and 2019 using the National Health Insurance Service database (n = 51,849,591 in 2019). Diagnosis of RI comorbidities were confirmed with International Classification of Disease, Tenth Revision, Clinical Modification codes. Epidemiologic characteristics, distribution of comorbidities according to etiologic mechanisms, and trend of antithrombotic agents were estimated. RESULTS During the 7-years, 10,496 patients were newly diagnosed with RI. The incidence rate increased from 2.68 to 3.06 per 100,000 person-years during the study period. The incidence rate of RI increased with age peaking in the 70s with 1.41 times male predominance. The most common comorbidity was hypertension, followed by dyslipidemia and diabetes mellitus. Regarding etiologic risk factor distribution, high embolic risk group, renovascular disease group, and hypercoagulable state group accounted for 16.6%, 29.1%, and 13.7% on average, respectively. For the antithrombotic treatment of RI, the prescription of antiplatelet agent gradually decreased from 17.0% to 13.0% while that of anticoagulation agent was maintained around 35%. The proportion of non-vitamin K antagonist oral anticoagulants remarkably increased from only 1.4% to 17.6%. CONCLUSION Considering the progressively increasing incidence of RI and high prevalence of coexisting risk factors, constant efforts to raise awareness of the disease are necessary. The current epidemiologic investigation of RI would be the stepping-stone to establishing future studies about clinical outcomes and optimal treatment strategies.
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Affiliation(s)
- Dong-Eon Kim
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Inki Moon
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Suyeong Park
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Minae Park
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Sojeong Park
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Seong Soon Kwon
- Division of Cardiology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Min Gyu Kong
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyun Woo Park
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyung Oh Choi
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hye-Sun Seo
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Yoon Haeng Cho
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Nae Hee Lee
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jon Suh
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
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He Y, Hu Y, Tian L, Qiu C, Li D, Xiang Y, Wang X, He Y, Wang X, Shang T, Zhu Q, Chen T, Li Z, Zeng Q, Wu Z, Zhang H. Acute Renal Infarction Due to Symptomatic Isolated Spontaneous Renal Artery Dissection: A Rare and Fatal Disease. J Endovasc Ther 2023:15266028231168352. [PMID: 37154346 DOI: 10.1177/15266028231168352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To report demographics and clinical, laboratory, and imaging features of acute renal infarction (ARI) due to symptomatic isolated spontaneous renal artery dissection (SISRAD) and to analyze outcomes after the initial therapy for SISRAD. METHODS Thirteen patients with ARI due to SISRAD between January 2016 and March 2021 were enrolled in this retrospective study. We reviewed the demographics, clinical, laboratory, and imaging features (location of the infarct kidney, the branch artery involved by dissection, true lumen stenosis, false lumen thrombosis, and aneurysm), treatment modalities, and follow-up results; analyzed the difference between SISRAD and other causes of ARI; and propose an appropriate therapy strategy for SISRAD based on our data and literature. RESULT Patients with ARI due to SISRAD were mostly young men (43 [24-53] years; 12/13 [92%]). No patients had atrial fibrillation or acute kidney injury at admission (0/13). All 13 patients received conservative treatment as the initial treatment. Sixty-two percent (8/13) of patients progressed, and 88% (7/8) of them had dissection aneurysm on the admission computed tomographic angiography (CTA) image. Seventy-five percent (6/8) of patients underwent endovascular intervention as follows, stent placement in 1 patient, renal artery embolization in 1, and stent placement with embolization in 4. Two patients with disease progression died: 1 during the conservative treatment period and 1 after the stent placement. Thirty-eight percent (5/13) of patients in remission continued to receive conservative treatment, none of whom had dissection aneurysm on the admission CTA. CONCLUSION Symptomatic isolated spontaneous renal artery dissection is a rare and fatal disease. For young ARI patients with no previous history of tumors and cardiogenic diseases, CTA examination is recommended to exclude SISRAD. Dissection aneurysm seems to be a risk of progression for SISRAD in this series. Conservative treatment, a recognized initial treatment, has a good effect on patients without dissection aneurysm, and we recommend endovascular intervention as the initial treatment for the patient with dissection aneurysm at admission. Multicenter clinical studies are needed to explore a more-appropriate treatment for patients with SISRAD. CLINICAL IMPACT This article report the related factors, risks, demographics and laboratory data of Acute renal infarction (ARI) due to Symptomatic isolated spontaneous renal artery dissection (SISRAD) and explore a better initial therapy strategy for SISRAD. It will help improve the effectiveness of SISRAD treatment and reduce the mortality rate from this rare but lethal disease.
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Affiliation(s)
- Yangyan He
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yujian Hu
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Lu Tian
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yilang Xiang
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaohui Wang
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yunjun He
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xun Wang
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Shang
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Qianqian Zhu
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Tianchi Chen
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenjiang Li
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Qinglong Zeng
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Yihan L, Guanqi F, Tong H, Junye G, Zhong J, Chen T. Case Report: Acute Renal and Splenic Infarctions Secondary to Atrial Fibrillation. Front Cardiovasc Med 2022; 9:879322. [PMID: 35686039 PMCID: PMC9171008 DOI: 10.3389/fcvm.2022.879322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Acute renal and splenic infarctions are an uncommon condition that can result from obstruction or decrease of renal and splenic arterial flow. We described a 73-year-old woman who presented with right flank pain and nocturnal dyspnea. The computed tomography (CT) scan with intravenous contrast showed multiple infarcts in both bilateral kidneys and spleen. Serum creatinine clearance was impaired. Further investigation by electrocardiogram (ECG) and 24-h Holter revealed that the patient had paroxysmal atrial fibrillation (PAF). Transthoracic and transesophageal echocardiographic findings were unremarkable except for severe spontaneous echo contrast (SEC) in the left atrial appendage. The development of thromboembolic renal and splenic infarction was attributed to embolism caused by atrial fibrillation. Anticoagulant therapy was initiated with low molecular weight heparin (LMWH) and followed by an oral anticoagulant. To manage PAF and prevent further embolism, the “One-stop” procedure, including atrial fibrillation catheter ablation and left atrial appendage occlusion (LAAO), was applied to this patient. Follow-up at 1 month showed normal sinus rhythm, improved renal function, and relieved renal and splenic infarction.
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ÇETİNKAYA HB, ALATLI T. Laboratory parameters can be used to differentiate renal infarction and urolithiasis in patients who are admitted to the emergency department with flank pain. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.926837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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KARTAL İ, ALKIŞ O, ÇETİNKAYA B, ÇELEN S, ARAS B. Clinical Approach to Renal Artery Thromboembolism. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2020. [DOI: 10.25000/acem.761573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Salomon du Mont L, Agag G, Malakhia A, Rinckenbach S. Impact of Accessory Renal Artery Coverage on Renal Function during Endovascular Aortic Aneurysm Repair. Ann Vasc Surg 2020; 71:402-410. [PMID: 32795649 DOI: 10.1016/j.avsg.2020.07.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Long-term outcomes of accessory renal artery (ARA) coverage after endovascular aneurysm repair (EVAR) are unknown. We analyzed the impact of ARA coverage on renal function long-term. METHODS This retrospective, monocentric study included patients treated by EVAR between 2008 and 2016. Patients with at least one ARA covered with EVAR (ARA group) were compared with patients with no covered ARA (control group). Renal function was determined by estimating the glomerular filtration rate (eGFR) and graded according to chronic kidney disease (CKD) classification stages. RESULTS A total of 184 patients were included (ARA group, n = 25; control group, n = 159). Renal risk factors were similar in the 2 groups. Mean (±standard deviation) duration of follow-up was 41.6 ± 25.8 months. Preoperative eGFR (mL/min/1.73 m2) was 68.9 ± 17.8 in the ARA group and 72.5 ± 17.4 in the control group (P = 0.33), with a similar decline in the 2 groups during follow-up (-6.52 ± 11.6 ARA group vs. -6.43 ± 13.8 control group; P = 0.97). At the end of the study, 8 ARA patients and 56 controls had deteriorated by one CKD stage (32% vs. 35.2%, respectively; P = 0.75). Rate of renal infarction was significantly higher in the ARA group (96% vs. 1.9%; P < 0.0001). In multivariate analysis, suprarenal fixation was identified as a risk factor for a decline in renal function (odds ratio = 2.01 [95% confidence interval: 1.05-3.84]; P = 0.04). CONCLUSIONS ARA coverage after EVAR does not appear to affect renal function long-term. Suprarenal fixation led to a greater decline in renal function.
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Affiliation(s)
- Lucie Salomon du Mont
- Service de Chirurgie Vasculaire et Endovasculaire, CHU Besançon, Besançon, France; EA3920, UFR Santé, Université de Bourgogne-Franche-Comte, Besançon, France.
| | - Geoffrey Agag
- Service de Chirurgie Vasculaire et Endovasculaire, CHU Besançon, Besançon, France
| | | | - Simon Rinckenbach
- Service de Chirurgie Vasculaire et Endovasculaire, CHU Besançon, Besançon, France; EA3920, UFR Santé, Université de Bourgogne-Franche-Comte, Besançon, France
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el Barzouhi A, van Buren M, van Nieuwkoop C. Renal and Splenic Infarction in a Patient with Familial Hypercholesterolemia and Previous Cerebral Infarction. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:1463-1466. [PMID: 30531677 PMCID: PMC6298247 DOI: 10.12659/ajcr.911990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 47 Final Diagnosis: Acute renal and splenic infarction Symptoms: Flank pain • low-grade fever Medication: — Clinical Procedure: CT scan Specialty: Nephrology
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Affiliation(s)
| | | | - Cees van Nieuwkoop
- Department of Internal Medicine, Haga Teaching Hospital, Hague, Netherlands
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Huang CW, Lee MJ, Hsu CY, Chou KJ, Fang HC, Wang LJ, Chen CL, Huang CK, Chen HY, Lee PT. Clinical outcomes associated with anti-coagulant therapy in patients with renal infarction. QJM 2018; 111:867-873. [PMID: 30215794 DOI: 10.1093/qjmed/hcy205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with renal infarction are vulnerable to thromboembolic complications with poor outcomes. There is limited report concerning the effect of anti-coagulant therapy in this population. AIM To assess the impact of anti-coagulant therapy on outcomes in patients with renal infarction. DESIGN A retrospective cohort study of 101 renal infarction patients was conducted. METHODS The association between anti-coagulant therapy, all-cause mortality, thromboembolic complications and renal outcome was evaluated. Demographic data and comorbidities were collected for analysis. Anti-coagulant therapy was treated as a time-dependent variable. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multi-variate Cox proportional hazards models. RESULTS Fifty-seven (56.4%) patients with renal infarction received anti-coagulant therapy during the study period. The all-cause mortality rate was 7.56 per 100 patient-years. Age (HR 1.05, 95% CI 1.02-1.08) was a risk factor for all-cause mortality and anti-coagulant therapy was associated with a 92% improved survival (HR 0.08, 95% CI 0.02-0.34). Twelve (11.9%) thromboembolic events occurred following renal infarction. Current smoking (HR 10.37, 95% CI 1.60-67.43) had an adverse effect and anti-coagulant therapy (HR 0.14, 95% CI 0.03-0.73) had a significant protective impact on thromboembolic complications. There was no significant association between anti-coagulant therapy and long-term renal outcome in renal infarction patients including the monthly change in the estimated glomerular filtration rate (eGFR), the incidence of eGFR reduction of more than 50% and end-stage renal disease. CONCLUSION Anti-coagulant therapy in patients with renal infarction was associated with better survival and reduced thromboembolic complications.
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Affiliation(s)
- Chien-Wei Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - M-J Lee
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-Y Hsu
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - K-J Chou
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - H-C Fang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - L-J Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-L Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - C-K Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - H-Y Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
| | - P-T Lee
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan
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Eren N, Gungor O, Kocyigit I, Guzel FB, Erken E, Altunoren O, Tatar E, Eroglu E, Senel E, Kaya B, Paydaş S, Onan B, Sahin S, Yilmaz M, Ulu S, Gursu M, Ozkok A, Yildiz A, Kurultak I, Ucar AR, Tanrisev M, Turgutalp K, Turan MN, Huzmeli C, Soypacaci Z, Akdam H, Huddam B, Adibelli Z, Kara E, Inci A, Turkmen E, Tekce H, Dogukan A, Turkmen A. Acute renal infarction in Turkey: a review of 121 cases. Int Urol Nephrol 2018; 50:2067-2072. [PMID: 30251011 DOI: 10.1007/s11255-018-1979-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/05/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Renal infarction is a clinical condition which is caused by renal artery occlusion and leads to permanent renal parenchymal damage. In the literature, there are generally case reports on this subject, and few studies that include a large group of patients. Therefore, we aimed to present the data of a large group of patients who were diagnosed with acute renal infarction in our country in this retrospective study. METHODS The data of patients who were diagnosed with acute renal infarction according to clinical and radiological findings in Turkey in the last 3 years were examined. For this purpose, we contacted with more than 40 centers in 7 regions and obtained support from clinically responsible persons. Demographic data of patients, laboratory data at the time of diagnosis, tests performed for etiologic evaluation, given medications, and patients' clinical status during follow-up were obtained from databases and statistical analysis was performed. RESULTS One-hundred and twenty-one patients were included in the study. The mean age was 53 ± 1.4 (19-91) years. Seventy-one (58.7%) patients were male, 18 (14.9%) had diabetes, 53 (43.8%) had hypertension, 36 (30%) had atrial fibrillation (AF), and 6 had a history of lupus + antiphospholipid syndrome (APS). Forty-five patients had right renal infarction, 50 patients had left renal infarction, and 26 (21.5%) patients had bilateral renal infarction. The examinations for the ethiologies revealed that, 36 patients had thromboemboli due to atrial fibrillation, 10 patients had genetic anomalies leading to thrombosis, 9 patients had trauma, 6 patients had lupus + APS, 2 patients had hematologic diseases, and 1 patient had a substance abuse problem. Fifty-seven (57%) patients had unknown. The mean follow-up period was 14 ± 2 months. The mean creatinine and glomerular filtration rate (GFR) values at 3 months were found to be 1.65 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. The final mean creatinine and GFR values were found to be 1.69 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. CONCLUSIONS Our study is the second largest series published on renal infarction in the literature. More detailed studies are needed to determine the etiological causes of acute renal infarction occurring in patients.
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Affiliation(s)
- Necmi Eren
- Nephrology Department, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Ozkan Gungor
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Fatma Betul Guzel
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ertugrul Erken
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Orcun Altunoren
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Erhan Tatar
- Department of Nephrology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Eray Eroglu
- Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Egemen Senel
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Bulent Kaya
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Saime Paydaş
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Bilen Onan
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Safak Sahin
- Department of Internal Medicine, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey
| | - Mumtaz Yilmaz
- Department of Nephrology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sena Ulu
- Department of Nephrology, Faculty of Medicine, Kocatepe University, Afyonkarahisar, Turkey
| | - Meltem Gursu
- Department of Nephrology, Faculty of Medicine, Bezmi Alem University, Istanbul, Turkey
| | - Abdullah Ozkok
- Department of Nephrology, Medeniyet University Training and Research Hospital, Istanbul, Turkey
| | - Abdulmecit Yildiz
- Department of Nephrology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Ilhan Kurultak
- Department of Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ali Rıza Ucar
- Department of Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Tanrisev
- Department of Nephrology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Kenan Turgutalp
- Department of Nephrology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Mehmet Nuri Turan
- Department of Nephrology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Can Huzmeli
- Department of Nephrology, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Zeki Soypacaci
- Department of Nephrology, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Hakan Akdam
- Department of Nephrology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Bulent Huddam
- Department of Nephrology, Faculty of Medicine, Mugla University, Mugla, Turkey
| | - Zelal Adibelli
- Department of Nephrology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Ekrem Kara
- Department of Nephrology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayca Inci
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ercan Turkmen
- Department of Internal Medicine, Ordu State Hospital, Ordu, Turkey
| | - Hikmet Tekce
- Department of Nephrology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Ayhan Dogukan
- Department of Nephrology, Faculty of Medicine, Fırat University, Elazig, Turkey
| | - Aydin Turkmen
- Department of Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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The size of the renal artery orifice contributes to laterality of acute renal infarction. Clin Exp Nephrol 2018; 22:1128-1132. [PMID: 29572750 DOI: 10.1007/s10157-018-1566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/15/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Acute renal infarction (ARI) is a rare disease with atrial fibrillation being its main cause. The possible laterality of ARI is controversial. This study aimed to evaluate the association between anatomical features of the renal arteries and ARI. METHODS This was a single-center cross-sectional study that evaluated the anatomical and clinical features of renal arteries. The anatomical features of the renal arteries were assessed using computed tomography. RESULTS A total of 46 patients (mean age 71.3 ± 14.0 years; men, 59%) were enrolled. ARI involved the left kidney in 63%, right kidney in 28%, and both kidneys in 9% of patients. The right renal artery orifice was often higher than that of the left renal artery (71%). The angle of divergence from the abdominal aorta was similar on both sides. The left renal artery orifice was larger than that of the right (83 ± 24, 72 ± 24 mm2; p = 0.03, respectively). A larger left orifice was present in 72% of all cases. ARI involved the side with the larger orifice in 64% of patients. CONCLUSION The size of the renal artery orifice may be a factor that contributes to the laterality of ARI. Assessment of anatomical features is important when considering the laterality of the disease.
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Abstract
Renal infarction is a rare clinical entity that is not easily detected by
low-sensitivity ultrasound. We herein report a case of dermatomyositis with
renal infarction detected during corticosteroid therapy. The patient was
followed up for 18 months. A woman who was clinically diagnosed with
dermatomyositis complained of severe pain in the right flank of the low back and
abdomen, accompanied by nausea and vomiting during corticosteroid therapy. Based
on the findings of routine blood tests, abdominal X-ray radiography, and
abdominal ultrasound, the patient was diagnosed with acute gastroenteritis and
treated with levofloxacin. However, her symptoms were not relieved. Abdominal
contrast-enhanced computed tomography revealed renal infarction. Clinicians
should be alert to the occurrence of thrombosis, especially when it manifests as
vasculitis in patients with rheumatic disease who complain of severe abdominal
pain, because it may suggest the presence of renal infarction.
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Affiliation(s)
- Ti Zhang
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, the Second Military Medical University, Shanghai, China
| | - Xin Liu
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, the Second Military Medical University, Shanghai, China
| | - Huji Xu
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, the Second Military Medical University, Shanghai, China
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