Felis ISSN 2398-2950

Kidney: thromboembolism

Synonym(s): Renal thromboembolism

Contributor(s): Penney Barber, Jana Gordon

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 Kidney: 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.

Pathogenesis

Etiology

Abnormal blood flow

Hypercoagulation

Trauma

  • Septic.
  • Trauma, eg to large or small renal vessels at surgery; road traffic accident.
  • Iatrogenic, eg after "Tru-cut" liver biopsy.

Pathophysiology

  • Occlusion of the renal artery or vein with a thrombus or embolism. Requires one or more of the following: hypercoagubable state, vascular stasis, endothelial damage.
  • Thrombus/embolus in major renal vessel   →   renal ischemia Kidney: ischemia and tubular damage    →   acute renal failure if extensive renal damage.
  • Thrombus/embolus in a smaller vessel   →   occluded   →   renal infarct   →   ischemia   →   damaged renal tissue.

Timecourse

  • Acute.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers


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