Renal infarction: Difference between revisions

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==Evaluation==
==Evaluation==
Laboratory
Laboratory
*CBC with differential/CMP, LDH, urinalysis, urine culture
*CBC with differential, CMP, LDH, urinalysis, urine culture
* [[EKG]]- to evaluate for arrhythmia 


* EKG- to evaluate for arrhythmia 
Imaging:<ref>
 
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.</ref>
Imaging:  
*CT with IV contrast (preferred study)
*CT w/ IV contrast (preferred study)
*[[Renal ultrasound]] - less senstive
*Ultrasound - less senstive
*MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis)
*MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis)
*Radioisotope scan - not commonly used
*Radioisotope scan - not commonly used
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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 12:19, 23 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

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:[1]

  • CT with IV contrast (preferred study)
  • Renal 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

  1. 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.