You are here: Urology Textbook > Kidneys > Kidney infarction
Kidney Infarction
Definition of Renal Artery Embolism and Kidney Infarction
Renal artery embolism leads to a sudden interruption of blood flow in the renal artery or their main segmental branches and to ischemic kidney infarction. A hemorrhagic renal infarction can be the result from a renal vein thrombosis.
Etiology (Causes) of Kidney Infarction
- Thromboembolic event (90%). Risk factors are atrial fibrillation, mitral valve disease, coronary heart disease, heart failure, other heart diseases, cardiac surgery, aortic aneurysm, renal artery aneurysm or renal artery stenosis.
- Hemorrhagic renal infarction due to renal vein thrombosis
Signs and Symptoms
- Flank pain or abdominal pain
- Hematuria
- Arterial hypertension
- Irregular heart rate
- Nausea, vomiting
- Oligouria, Anuria
Diagnostic Work-Up
Urine:
Signs for kidney infarction are proteinuria, microhematuria or hematuria.
Laboratory tests:
Signs for kidney infarction are an increase in GOT, LDH, CK (intracellular enzymes indicating necrosis) and creatinine (if significant renal tissue is affected).
Ultrasonography:
Doppler ultrasonography of the kidney can quickly confirm the diagnosis in kidney infarction.
Abdominal CT:
Easy diagnosis in post contrast images with wedge-shaped areas without contrast enhancement [fig. partial renal infarction]. The cortical rim sign is seen in 50% of the patients after several hours or days of infarction: a thin rim of cortex enhances due to collateral capsular perfusion.
![]() |
Computed tomography of a left-sided partial renal infarction. Additional finding: a partial splenic infarction can be seen. With kind permission of Prof. Dr. K. Bohndorf, Augsburg. |
Digital subtraction angiography (DSA):
Gold standard for diagnosis of acute vascular occlusion with the option for invasive treatment..
Treatment of Kidney Infarction
Conservative Treatment of Kidney Infarction:
Cornerstones of conservative treatment are analgesics, regulation of blood pressure and systemic heparinization. A thrombolytic therapy should be considered; the decision depends on the extent of infarction and the remaining renal function.
PTA or Surgical Therapy:
Percutaneous transluminal angioplasty or vascular surgery are indicated for patients with bilateral embolism or infarction of a solitary kidney, if diagnosis is made in time. The time window for successful interventions is unclear, interventions have to be done as an emergency. Please see anatomic or extra-anatomic bypass surgery ( treatment of renal artery stenosis).
Urologic Surgery | Index | Renal AV fistula |
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
References
Deutsche Version: Niereninfarkt