Renal infarction: Difference between revisions
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==Background== | ==Background== | ||
*Low ED incidence, approximately 1 per 90 to 100, 000 visits a year | *Low ED incidence, approximately 1 per 90 to 100, 000 visits a year | ||
*Diagnosis frequently missed due to mimicking symptoms similar to other more frequent complaints such as pyelonephritis and nephrolithiasis | |||
*Caused by interruption of blood supply to kidney | *Caused by interruption of blood supply to kidney | ||
===Major causes=== | ===Major causes=== | ||
*Cardioembolic disease | *Cardioembolic disease | ||
*Renal artery injury | *Renal artery injury | ||
*Hypercoagulable state | *Hypercoagulable state | ||
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==Clinical Features== | ==Clinical Features== | ||
*[[Flank pain]] | *[[Flank pain]] | ||
*Nausea, vomiting | |||
*Sudden onset | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Nephrolithiasis | |||
*Pyelonephritis | |||
*Mesenteric ischemia | |||
*Lower lobe pneumonia | |||
==Evaluation== | |||
Laboratory | |||
*CBC with differential/CMP, LDH, urinalysis, urine culture | |||
* EKG- to evaluate for arrhythmia | |||
Imaging: | |||
* CT w/ IV contrast | *CT w/ IV contrast (preferred study) | ||
*Ultrasound - less senstive | |||
*MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis) | |||
*Radioisotope scan - not commonly used | |||
==Management== | ==Management== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: A case report and review of the literature. Canadian Urological Association Journal. 2015;9(3-4):E237-E239. doi:10.5489/cuaj.2466. | |||
[[Category:Renal]] | [[Category:Renal]] | ||
Revision as of 20:18, 22 November 2017
Background
- Low ED incidence, approximately 1 per 90 to 100, 000 visits a year
- Diagnosis frequently missed due to mimicking symptoms similar to other more frequent complaints such as pyelonephritis and nephrolithiasis
- Caused by interruption of blood supply to kidney
Major causes
- Cardioembolic disease
- Renal artery injury
- Hypercoagulable state
- Dissection
- Vasculitis
Clinical Features
- Flank pain
- Nausea, vomiting
- Sudden onset
Differential Diagnosis
- Nephrolithiasis
- Pyelonephritis
- Mesenteric ischemia
- Lower lobe pneumonia
Evaluation
Laboratory
- CBC with differential/CMP, LDH, urinalysis, urine culture
- EKG- to evaluate for arrhythmia
Imaging:
- CT w/ IV contrast (preferred study)
- Ultrasound - less senstive
- MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis)
- Radioisotope scan - not commonly used
Management
Disposition
See Also
References
Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: A case report and review of the literature. Canadian Urological Association Journal. 2015;9(3-4):E237-E239. doi:10.5489/cuaj.2466.