Introduction
- Occlusion of renal artery or vein with a thrombus or embolism.
- Cause : hypercoagulable state, most commonly: secondary to cardiac disease.
- Signs : acute renal failure
; asymptomatic for small thrombi/emboli. - Diagnosis : clinical findings consistent with acute renal failure: azotemia, electrolyte disturbances, metabolic acidosis, variably concentrated urine, uremia.
- Treatment : medical or surgical removal of embolus, manage renal failure/underlying disease.
- Prognosis : good if small, guarded to poor for large vessels, dependent on underlying disease.
Diagnosis
Clinical signs
- Asymptomatic.
- Associated with underlying cause of renal thromboembolism.
- Small bladder if acute renal failure.
Diagnosis
Differential diagnosis
- Other causes of acute renal failure .
- Renal cyst or abscess . Ultrasound should be able to differentiate between infarct, cyst or abscess.
- Renal neoplasia .
Sequelae
Prognosis
- Good: if thrombus lodged in small vessel.
- Guarded: if thrombus lodged in major vessel.
Expected response to treatment
- Same as acute renal failure .
- Depends on underlying cause of renal thromboembolism.
