Renal infarction: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Nephrolithiasis | *[[Nephrolithiasis]] | ||
*Pyelonephritis | *[[Pyelonephritis]] | ||
*Mesenteric ischemia | *[[Mesenteric ischemia]] | ||
*Lower lobe pneumonia | *Lower lobe [[pneumonia]] | ||
==Evaluation== | ==Evaluation== | ||
Revision as of 12:20, 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
- Flank pain
- Nausea, vomiting
- Sudden onset
Differential Diagnosis
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
- ↑ 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.